AHIP Solutions SmartBrief
PHTI task force evaluates AI for health care delivery | Financial improvement forecast for nonprofit hospitals | Autoimmune diseases affect 15M in US, study finds
Created for np3kckdy@niepodam.pl |  Web Version
January 14, 2025
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Top Story
The CMS has proposed a 2.23% increase in Medicare Advantage benchmark payments for 2026, translating to a $21 billion rise in payments to MA plans. This proposal contrasts with a 0.16% decrease last year and continues the implementation of the MA risk adjustment model.
Full Story: Fierce Healthcare (1/13) 
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Accurate medication histories are key to providing quality care for members. But health plans often lack comprehensive, real-time medication histories. Now, faster access to more accurate information is helping plans improve outcomes while reducing costs.
Learn more.
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Emerging Trends
PHTI task force evaluates AI for health care delivery
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The Peterson Health Technology Institute has formed a task force to evaluate AI technologies for health care delivery, focusing on ambient scribes and revenue cycle management tools. The task force, which has been in operation for six months, includes executives from a dozen health systems, such as UC San Diego Health and Intermountain Health. A report on AI-powered ambient scribes and revenue cycle management tools is expected this quarter.
Full Story: Fierce Healthcare (1/13) 
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Nonprofit hospitals are expected to see better financial performance this year, driven by easing labor costs and increased patient volumes, according to Fitch Ratings. Some hospitals, particularly smaller ones and those in areas with stagnant population growth, may continue to struggle.
Full Story: Chief Healthcare Executive (1/8) 
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Medical Update
A study in the Journal of Clinical Investigation found that more than 15 million people in the US were diagnosed with autoimmune diseases from 2011 to 2022, with women nearly twice as likely to be affected as men. The research, using electronic health records from six health care systems, highlights rheumatoid arthritis as the most prevalent condition.
Full Story: Medscape (1/13) 
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Navigating Medicare: Mental Health Coverage
Join our upcoming webinar, where MCG Health Associate Managing Editor Leigh Elwood, MSN, RN, and Michael Parrozzo, BSN, RN, Senior Nurse Editor, explore challenges in accessing mental health care and the current benefits Medicare provides for mental health services. Register here.
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Emerging Trends: Social Determinants of Health
A study in JAMA Network Open identified three main factors driving COVID-19 vaccine hesitance among Black women: mistrust of the health care system and government, concerns about vaccine safety and a perception that vaccination incentives and promotion tactics are coercive or disrespectful. "Rather than being targeted with these promotional strategies, participants preferred clear, scientific information about vaccine safety and mechanisms," co-author Brittany Slatton said.
Full Story: MedPage Today (free registration) (1/9) 
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Health Plan Company News
Solutions Provider News
Pharma News
Members of the Sackler family who own Purdue Pharma have reportedly agreed to increase their contribution to $6.5 billion in a bankruptcy settlement of opioid lawsuits after the Supreme Court rejected a previous plan. The proposal includes financial settlements for claimants and the possibility for those who reject the offer to pursue litigation against the Sacklers.
Full Story: The Wall Street Journal (1/13),  The Times (London) (tiered subscription model) (1/13) 
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Policy Watch
Biden to propose nicotine cap for cigarettes
(Pixabay)
President Joe Biden's administration is expected to propose legislation limiting nicotine levels in cigarettes, excluding e-cigarettes and nicotine replacement products, in a last-minute effort to combat tobacco use. The proposal may aim to reduce nicotine levels by up to 95% to make cigarettes less addictive, potentially saving millions of lives.
Full Story: NBC News (1/10) 
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