In the News: June 20–27

Artificial Intelligence Policy Enhancements Address Quadruple Aim

A recent American Medical Association (AMA) article discusses enhancements to policies regarding the use of augmented intelligence, or artificial intelligence (AI), within the clinical setting. The AMA initially adopted policies in 2018 that stated AI “should enhance the patient experience of care and outcomes, improve population health, reduce overall costs for the health care system while increasing value, and support the professional satisfaction of physicians and the health care team,” or in other words, address the quadruple aim.

Enhancements to the policies now call for increased emphasis on greater engagement with stakeholders, policy makers—including national medical specialty societies—and associations to ensure  AI technologies support and receive the satisfaction of physicians and the health care team. Additionally, the newly adopted policy also advocates for greater oversight and regulation of AI, as well as payment and coverage.

Organizations are increasingly expanding their virtual health capabilities and turning their attention to the incorporation of AI and other emerging technologies. Sg2 believes that establishing AI application guidelines in health care is a pressing issue as AI’s adoption and utilization rapidly accelerate. To learn more about how your organization can achieve long-term success in virtual health and AI capabilities, consider the recommendations in our most recent edition of the Sg2 Virtual Health Newsletter.

Deaths From Suicide, Substance Abuse Differ Across States

The Commonwealth Fund recently released its 2019 Scorecard on State Health System Performance, ranking US states on their performance regarding access to care, health care cost and several health outcome measures. One ranked area includes deaths from suicides and substance abuse, which have increased across the country; however, different states have been impacted in different ways. Several states in the southeast, as well as the mid-Atlantic and the New England area, have been heavily impacted by the opioid epidemic.

In states like Pennsylvania and Maryland, the death rates from drug overdoses were 5 times higher than from alcohol. States in the northeast, such as Oregon and Wyoming, saw higher death rates from suicide and alcohol than drugs. In 2017, West Virginia had a drug overdose death rate that was more than double the national average, with 9 states seeing drug overdose mortality rates more than triple since 2005.

Approximately 92% of the 18+ million adults with a substance abuse condition are not receiving treatment, which means there is an overwhelming unmet need that health systems must address. While planning care for this population may seem daunting, Sg2 challenges health systems to integrate upstream models of care into their behavioral health System of CARE to increase access and improve outcomes for patients. For examples of upstream care models, read the inaugural Sg2 Service Line Roundup: Cardiovascular, Behavioral Health and Pediatrics.

Health Care Costs Are Projected to Rise 6% in 2020

A recent Modern Healthcare article projects a rise in medical costs next year as utilization rates stagnate. Despite employer attempts to curtail unnecessary care with high deductible health plans, medical cost growth has outpaced inflation. The 2020 projected rise of 6% in cost aligns with average medical cost inflation over the past 5 years, which is a marked decline from the double-digit spikes in the early 2000s.

Many consumers are delaying or refusing health care due to rising costs. In a study conducted by PricewaterhouseCoopers Health Research Institute, one-third of all respondents said they did not have enough savings to cover their deductible. Consumers with chronic conditions and those requiring multiple prescriptions are particularly hard hit. To combat rising costs, employers are creating work-site clinics that improve productivity, pushing narrow networks with lower-cost providers and helping coordinate care.

Employer contracting, ranging from occupational health services to total cost of care contracts, offers health systems an opportunity to foster relations with employers and capture commercial volumes. To learn more about employer contracting, please read the Sg2 report Employer Contracting: Strategies for Netting Commercial Revenue and Volumes.

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