What It Costs To Chase Payment

What It Costs To Chase Payment

A recent MedCity News survey reveals that providers end up investing about 2-10% of the collection value of their claims on subsequent efforts to chase down payment, scrubbing away at margins and slowing administrative workflows in revenue cycle management. At the same time, 90% of hospital and physician practice respondents say they are at least somewhat interested in artificial intelligence tech tools to make improvements in billing, and about 66% already have experience with such …

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Patients, Telehealth Providers Stretch Weight Loss Drugs With Microdosing

Patients, Telehealth Providers Stretch Weight Loss Drugs With Microdosing

Trends show that some patients are choosing to microdose their glucagon-like peptide 1 receptor agonists (GLP-1RA) prescriptions for diabetes and weight loss, whether a provider advises it or not. It’s believed that microdosing can be helpful to quell significant gastrointestinal side effects or to titrate scheduled dosing with individualized provider recommendations, however, microdosing is still considered unconventional, according to the American Diabetes Association (ADA). For example, each semaglutide multidose pen delivers about 72 unnumbered “clicks” …

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Do Viral Infections Increase Risk Of Cardiovascular Disease?

Do Viral Infections Increase Risk Of Cardiovascular Disease?

A systematic review and meta-analysis of 155 studies evaluated the literature on the link between any viral infection and the odds of heart attack and stroke risk. Authors found influenza and COVID infections raised such risks as much as 3-to-5-fold in the weeks following the initial infection, as published in the Journal of the American Heart Association. Also noted in a related news release on the study, overall, the findings suggest acute and chronic viral …

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Hand, Foot, And Mouth Disease Surges In Mid-Atlantic Regions

Hand, Foot, And Mouth Disease Surges In Mid-Atlantic Regions

Virginia is seeing a surge in cases of hand, foot, and mouth disease, according to the state’s department of health. Reports show steep increases in visits to urgent care and emergency departments compared to the past 3 years, reaching a peak of about 4% of visits in recent weeks. The state is tracking about 60 reported outbreaks. Additionally, the District of Columbia has reported 197 emergency department visits related to the disease in September, primarily …

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Patients With Frequent Glucose Monitor Use See Better Results

Patients With Frequent Glucose Monitor Use See Better Results

In a study of 9,258 adults with type 2 diabetes, frequent continuous glucose monitoring (CGM) use was linked to significantly greater HbA1C reductions over 12 months compared with no CGM use, as published in JAMA Network Open. Patients using their CGM devices on 270 days per year or more achieved a mean HbA1C decrease of −1.52 percentage points (95% confidence interval [CI], −1.73 to −1.32 percentage points) vs  −0.63 percentage points in nonusers (95% CI, …

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GLP-1 Scripts As High As 34% For Those With Diabetes And Obesity

GLP-1 Scripts As High As 34% For Those With Diabetes And Obesity

From 2010 to 2024, prescriptions for glucagon-like peptide 1 receptor agonists (GLP-1RAs) increased substantially among individuals with type 2 diabetes (T2D) and obesity, according to a research letter in JAMA Network Open, which examined electronic medical records of more than 300 million Americans. Rates rose from 2.4% to 34.3% among individuals with both T2D and obesity; from 0.6% to 13.7% in those with T2D only; and 0.04% to 7.1% in those with obesity only. The …

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LLMs Save Time For ED Discharge Notes

LLMs Save Time For ED Discharge Notes

When using a large language model (LLM) assistant for generating emergency department (ED) discharge notes at an academic 2,400-bed tertiary hospital in South Korea, physicians gained some worthwhile efficiencies, according to a comparative effectiveness study published in JAMA Network Open. Six emergency physicians created 300 manual notes, 300 LLM drafts, and 300 LLM-assisted notes from 50 patient cases, which were judged on a Likert scale ranging from 1 to 5. Compared with manual documentation, LLM-assisted …

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Cost-Of-Care Pressure Leads To Oak Street Clinic Closures

Cost-Of-Care Pressure Leads To Oak Street Clinic Closures

CVS Health plans to close 16 Oak Street Health centers, representing about 7% of its total portfolio of these senior-focused primary care clinics. Doors will shutter by the end of February, and CVS cites rising medical costs as the main reason driving the reduction, according to Forbes. The company did not specify which locations will close but said it will continue to operate 230 Oak Street clinics across 27 states. Increased costs to deliver care …

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Fewer Kids Received Antivirals For Flu During Pandemic Years

Fewer Kids Received Antivirals For Flu During Pandemic Years

In a cross-sectional study of 3,378 influenza-positive children across 7 U.S. pediatric hospitals, researchers found a substantial decline in antiviral prescribing in the emergency department during the COVID-19 pandemic, as published in JAMA Network Open. Among 2,514 children at higher risk of severe influenza, 32.2% received antivirals in the prepandemic era (December 1, 2016, to March 31, 2020), compared with 15.6% during late pandemic era (July 1, 2021, to June 30, 2023)—a 53% relative decrease. …

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Insurers Automatically Reduce Pay For Some E/M Codes 

Insurers Automatically Reduce Pay For Some E/M Codes 

Several large health insurers are drawing provider backlash for relatively new payment policies that reduce certain reimbursements. Cigna is automatically downcoding 6 evaluation and management (E/M) billing codes (99204- 99205, 99214-99215, 99244-99245) for a small percentage of providers starting this month, for example, resulting in lower payments for some routine office visits. The insurers are leveraging algorithms and claims data to automatically downgrade the codes—often relying on third party vendors to do the adjustments. According …

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