Productive Edge

As of yesterday, CMS mandates hospitals to report respiratory illness data to the CDC—reviving pandemic-era rules. Hospitals will need to track infections, bed capacity, and even report emergency conditions if crises arise and submit daily data on a weekly basis.The burden? Critics say it’s significant.

Is this the right way forward, or does it need a better approach?

CMS' hospital capacity reporting rule takes effect: 10 notes Beginning Nov. 1, CMS will require hospitals to report admission information related to respiratory illnesses, including capacity, to the CDC. The new rule reinstates some pandemic-era requirements that have been voluntary since May 1. 

Thousands in Massachusetts face potential insurance loss on January 1, 2025.

A major dispute between Point32Health and several Massachusetts hospitals over reimbursement rates threatens to disrupt care for patients at UMass Memorial Health, Tenet Healthcare's Saint Vincent Hospital, and MetroWest Medical Center.

This critical issue highlights the ongoing challenges within the healthcare system and the potential consequences for patients.

What are your thoughts on this?

Thousands in Central Mass. could lose insurance coverage on Jan. 1. What you need to know The development impacts 16,000 patients who may have to scramble to find alternative insurance plans.

Mass General Brigham aims to move 10% of its patients to at-home care, leveraging remote monitoring, virtual visits, and in-home services. Research suggests 30-40% of U.S. care could be safely managed at home in the future.

As patients demand more convenience, the "hospital-at-home" model is transforming healthcare by offering better patient experiences, reducing clinician burnout, and easing pressure on brick-and-mortar facilities. The question is—will CMS extend coverage for these programs beyond 2024?
https://hubs.li/Q02VFQmm0

Why Mass General Brigham Wants to Move 10% of Patient Care to the Home - MedCity News At HIMSS24, Heather O'Sullivan, Mass General Brigham's president of healthcare at home, said that the health system wants to move 10% of all its medical patients to the home. She argued that there is "no greater model of care for being patient-centric," and highlighted the care modality's ability to...

In 2025, individual health plan premiums in Colorado will rise by 5.6% on average, with small-group employers seeing a 7% increase. However, Colorado Option plans are softening the blow with only a 4.6% increase, and the state’s reinsurance program is saving consumers even more—preventing premiums from rising 24% higher than projected.

📅 Open enrollment begins Nov. 1. Now’s the time to explore options through Connect for Health Colorado and find savings: https://hubs.li/Q02VFzSW0

Here’s how much Colorado health insurance rates will increase in 2025 as open enrollment nears Coloradans enrolling in individual health insurance plans in 2025 will see an average increase of 5.6%. Small-group employers —  defined as those with 99 or fewer employees — will have an average increase of around...

For the first time in nearly 8 years, all health insurance plans under the Affordable Care Act in North Dakota will see premium hikes. Individual plans will increase up to 16.5% for Sanford Health and 15.94% for Blue Cross Blue Shield, with smaller group plans seeing similar jumps.

North Dakota Insurance Commissioner Jon Godfread warns, “The pool is being drained at an unsustainable pace,” citing rising healthcare costs as the driving factor. As businesses and individuals feel the impact, how will the industry respond to these growing pressures?
https://hubs.li/Q02VFzBW0

Health insurance through the ACA to go up as much as 16.5 percent next year in ND NORTH DAKOTA – North Dakota Insurance Commissioner Jon Godfread says it’s the first time in his nearly eight years in office that all health insurance plans purchased through the Affordable Care Act will see increased premiums. For

Ready or not, Agentic AI is here.

Healthcare organizations can unlock its potential today—cutting claims processing by 30% and reducing prior authorization times by 40%.

💡 Explore the latest insights from Retiwalla to discover how AI agents are reshaping healthcare efficiency—and how to fast-track their impact in your organization.
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Demystifying Agentic AI: How AI Agents Can Change Healthcare Efficiency Now See how Agentic AI transforms healthcare by streamlining claims, speeding authorizations, and improving care coordination with smart, autonomous AI agents.

Manual tasks shouldn’t stand between care teams and better patient outcomes! 🚀 Care Advisor: Clinical leverages AI to automate the repetitive, freeing up time for what matters most—quality care. 💙

Ready to experience the difference? Learn more 👇
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Brick-and-mortar pharmacies are closing fast as consumers shift to digital and mail-order options. Rising costs, shrinking reimbursements, and retail theft have forced CVS, Walgreens, and Rite Aid to shutter hundreds of stores.

With satisfaction in physical locations declining, pharmacies are racing to stay relevant by introducing kiosks, digital platforms, and in-store clinics.

The future of pharmacy is smaller, faster, and more connected—but can the industry adapt in time?https://hubs.li/Q02VDWLy0

www.beckershospitalreview.com

2024 is pushing healthcare payers to the brink—with rising costs, shrinking margins, and shifting regulations. AI isn’t just a future plan; it’s a must-have for every payer’s strategy.

Edge’s AI Agent Accelerators deliver fast, tangible results—streamlining operations, slashing admin burdens, and unlocking savings in weeks. No overhauls needed.

In this latest article, industry expert Raheel Retiwalla shares how AI agents can help you tackle rising costs with confidence and stay ahead of the curve. Check it out: https://hubs.li/Q02Vp14G0

Why Payers Must Consider AI Now to Tackle Rising Costs in 2024 and Beyond Navigating workforce reductions, rising costs, and new regulations, healthcare payers must adopt AI now to streamline operations, cut expenses, and stay competitive.

Did you know that over 30 million people are now enrolled in Medicare Advantage plans? With an average beneficiary having access to 43 different options, it's clear that flexibility is at your fingertips. As healthcare costs evolve, the Medicare open enrollment period offers a crucial opportunity to compare plans and find the perfect fit for your needs.

Don't miss the latest guide to everything you need to know during the Medicare open enrollment period.

🔗 https://hubs.li/Q02TH9GJ0

Medicare open enrollment for 2025: Everything you need to know The annual period in which plans can be changed for Medicare enrollees is starting.

Healthcare organizations are swimming in data, but drowning in silos. This fragmented landscape hinders the potential of AI to truly transform care delivery.

A new article from argues we need a new approach to data management to unlock the power of . Here's why:

- Disconnected data hinders AI insights: poor data integration leads to incomplete pictures and flawed outcomes.
- AI thrives on clean, reliable data: silos breed inconsistencies and inaccuracies, limiting AI's potential.
- Unified data empowers AI to optimize patient care: a holistic view allows AI to identify patterns, predict risks, and personalize treatments.

Read the full article for insights on building a data foundation for GenAI success. ➡️

Healthcare organizations need a new approach to data management to unlock GenAI’s potential It’s time to shift from GenAI experimentation to meaningful implementation in healthcare with a strong focus on data integrity.

Nurses are the backbone of healthcare, and freeing up 20% of their shift through could revolutionize patient care. Dive into & Company's latest report to discover how AI can enhance nursing efficiency, the potential risks involved, and strategies for successful adoption. Explore the future of AI in healthcare and how it's set to transform the industry:

The pulse of nurses’ perspectives on AI in healthcare delivery Nurses are cautiously enthusiastic about AI. They are eager to share their knowledge of patient priorities in developing AI-powered tools but stress the importance of not sacrificing high-quality care.

Care managers face more tasks than ever: authorizing treatments, managing complex care plans, and keeping patients engaged. It’s no surprise that 46% of care managers feel burned out!

That’s where Care Advisor: Clinical comes in. Our AI solution simplifies workflows, reduces manual tasks, and frees up time for higher-value care activities.
Learn more here: https://hubs.li/Q02TG-V20

As healthcare evolves, so does Medicare, now embracing a value-based care approach that prioritizes quality over quantity. What does this mean for the 42% of Medicare beneficiaries enrolled in Medicare Advantage, and how does it affect outcomes?

Check out this blog to discover:

- The intricate structure of Medicare from Part A to D
- The significant shift towards value-based care
- How CMS is enhancing healthcare delivery to provide better care at lower costs

Read more about the future of Medicare and the proactive role of CMS in shaping healthcare 👉 https://hubs.li/Q02TDtd10

The Future of Medicare Lies in Value-Based Care Explore the segments and evolution of Medicare, its shift to value-based care, and how it benefits beneficiaries for better healthcare outcomes.

🌍 Happy Columbus Day from all of us at Productive Edge!

Today, we celebrate the spirit of exploration, innovation, and discovery—values that drive our passion for pushing the boundaries of technology. Just as Columbus set out to discover new worlds, we’re committed to helping organizations explore new horizons in digital transformation. Here’s to charting bold new paths together!

Transform data from a burden to a breakthrough! As we embrace the AI era, data isn't just necessary; it's a game-changer.

Discover how prioritizing data quality, democratizing access, and integrating AI can not only safeguard your data but propel your organization forward. Say goodbye to dark, duplicate, and dirty data. Embrace a data governance framework that fuels innovation and drives substantial business growth. Download the eBook:

Turn Your Data From Liability to Asset Extract long-term ROI from your data and build proactive data governance in the AI era. Download the eBook from Google Cloud.

Imagine healthcare that comes to you, not the other way around. With telehealth, say goodbye to the hassle of scheduling, long drives, and crowded waiting rooms.

From a mere 0.1% in 2019 to about 17% in 2023, telehealth isn't just the future—it's the now. Dive into our latest blog to discover how virtual care is reshaping healthcare, making it more accessible, cost-effective, and patient-centered than ever before.

Whether managing chronic conditions or accessing urgent care, telehealth means immediate, real-time care from the comfort of your home. Learn how it's not just changing, but dramatically improving health outcomes across the board:

The Doctor Will See You at Home Now Telehealth can not just make your patients healthier, but also create a more efficient business model for healthcare payers and providers, making care equitable and cost-efficient.

Did you know 40% of hospitals are losing money? Even with recent improvements in margins, many health systems face immense financial challenges.

The key to transforming operations isn’t just more beds or staff—it’s optimizing patient flow.

AI is the game-changer hospitals need to forecast demand, make smarter decisions, and allocate limited resources more effectively. From admission to discharge, AI can improve efficiency and boost patient outcomes. Learn more: https://bit.ly/3Nmlp4p

How AI Can Help Hospitals Overcome Patient Flow Barriers - MedCity News Artificial intelligence (AI) holds potential to forecast and predict where hospital leaders should direct limited resources such as clinicians, staff, and beds to improve operational efficiency and drive better patient outcomes.

Hurricane Helene’s impact goes beyond local devastation—it’s shaking up healthcare nationwide. The North Carolina plant that produces 60% of the country’s IV fluids has been forced to halt production due to flood damage, leaving hospitals across the U.S. scrambling for supplies.

IV fluids are essential for critical care, emergency rooms, and surgeries—without them, patient care is at serious risk. As hospitals brace for shortages, it’s a sobering reminder of the vulnerability in our supply chains.

Read more about the hurricane’s impact and why building resilience in healthcare manufacturing is now more crucial than ever. https://bit.ly/4eyd6yH

Hurricane Helene’s Unexpected Impact On U.S. Healthcare Delivery The destruction of a key manufacturing plant in North Carolina that produces 60% of intravenous fluids in the U.S. is the root cause of this patient-impacting crisis.

🌍❤️ On this World Heart Day, let's unite to raise awareness about cardiovascular disease, which remains the world's leading cause of death, taking an estimated 17.9 million lives each year. Fortunately, many of its risk factors are preventable through lifestyle changes and early detection.

How are you taking steps toward a heart-healthy lifestyle? Share your thoughts below! 💬👇

Health systems are facing big challenges: rising costs, workforce shortages, and growing consumer expectations for digital care. Yet, many aren’t investing enough in AI and digital transformation to stay ahead.

AI alone could save healthcare up to $360 billion! Are organizations missing out on this opportunity? Check out the latest findings from McKinsey & Company: https://hubs.li/Q02QX4WV0

Big changes in mental health coverage for 50M Americans experiencing a mental illness: the Biden-Harris Administration's final rule aims to ensure mental health benefits are on par with physical health care, but opinions are divided. Will it improve access or increase costs? Discover what key stakeholders are saying: https://hubs.li/Q02PGNsR0

Healthcare Leaders Clash on Mental Health Parity Final Rule - MedCity News The AMA came out in support of the Biden-Harris Administration's final rule on mental health parity, while AHIP and the Blue Cross Blue Shield Association argue that it will increase costs and negatively affect access to care.

Did you know that 137 terabytes of healthcare data are generated daily, and physicians spend an average of 15.5 hours per week on paperwork? The good news: AI is revolutionizing how healthcare organizations can leverage data to cut costs and boost profitability! Discover 8 ways to reduce expenses and unlock revenue potential and download Google Cloud's FREE eBook, Make Data and AI Work For You, to learn more: https://hubs.li/Q02PGHWK0

Make Data and AI Work For You: 8 Ways to Reduce Expenses and Boost Revenue Discover how data and AI can streamline healthcare operations, boost profitability, and enhance patient care. Learn actionable strategies for success.