#PNN In Other News

Here are some other local, state or national stories we are reading that may impact you, your practice or your patients.

CMS thinks artificial intelligence could help cut Medicare fraud | The CMS wants help figuring out how to use new technologies like artificial intelligence to cut fraud and abuse in Medicare and Medicaid, according to a request for information released Tuesday [Oct.22]. The agency is asking the private sector for advice on how emerging technologies can be used to ensure proper claims payment, reduce paperwork for providers and make sure its program integrity activities are efficient. It's interested in applying new technologies to program integrity efforts for its traditional fee-for-service programs as well as value-based care. Comments could address several of the CMS' challenges, including how to use technology to make sure it's only enrolling legitimate providers and suppliers. Currently, the agency relies on its records system, but it thinks new technology and data sources could spot problematic business relationships by automatically sifting through state and local information on business ownership and registration.

Health Care Providers Are Hiring the Wrong People | In his 2004 bestseller, “Moneyball,” Michael Lewis wrote “What begins as a failure of the imagination ends as a market inefficiency: when you rule out an entire class of people from doing a job simply by their appearance, you are less likely to find the best person for the job.” Lewis’s protagonist, Oakland A’s General Manager Billy Beane, disrupted the process of hiring baseball players. Beane realized that scouts let unconscious biases blind them to individuals who generate the very outcome their teams need — runs. Undeterred by scouting convention, Beane pursued players like Chad Bradford, despite his “funny-looking” form. Bradford and the A’s went on to a 20-game winning streak. In healthcare, we are overdue for a “Moneyball” revolution. The shift towards value-based payment has made it clear that our system needs to do a better job generating outcomes that matter to patients — a positive healthcare experience, improved health, and good quality of life. But healthcare’s current hiring practices can inhibit efforts to achieve this goal. We may not have a bias against people with a funny throw, but we have strong prejudices about race, class and educational attainment. Many of our conventions come from an era when healthcare was delivered primarily by doctors and nurses with elite training whose success depended mostly on content expertise. This paradigm is outdated; we now know that social, behavioral and relational factors — like social support, lifestyle, diet and even a patient’s relationship with her healthcare team — are critical drivers of health. Thus, the new healthcare workforce needs more than biomedical knowledge; it needs empathetic team players at all levels who can support patients holistically.

CMA objects to federal scope expansion under president’s executive order | President Trump recently signed an executive orderwith sweeping implications for Medicare, touting it as an alternative to “Medicare for All” proposals. Although the order is very broad and lacks details, it is clear that the administration is looking at eliminating regulations that require physician oversight of nurse practitioners and physician assistants. The California Medical Association (CMA) opposes any attempts to remove physician oversight over allied health professionals and believes that doing so would put the health and safety of patients at risk. “Since Day One, this administration has worked to undermine access to care and quality of care for patients,” said CMA President David H. Aizuss, M.D. “The president’s latest executive order suggests changes regarding scope of practice that would also have disastrous effects for patients.”

Report: Half of all U.S. nurses and doctors are burned out | Your doctor is more likely to be suffering from burnout than ever before. A new report from the National Academy of Medicine found that between 35% and 54% of nurses and doctors have symptoms of burnout. The causes of this widespread clinician burnout include unmanageable workloads, inadequate technology, and a lack of social support, the study found. The 321-page report included a review of available scientific research on clinician burnout. The report's authors said clinician burnout is a systematic, not individual, issue. Systematic issues include outdated technology, overworking medical students, expensive schools forcing students to take out high student loans, and a lack of peer support groups in hospitals. The issue of clinician burnout has reached a breaking point this year. Physician burnout reached an all-time high in 2019, after 79% of primary care doctors reported suffering from workplace-related stress. Nurses, meanwhile, went on strike in four states this summer, in part demanding better nurse-to-patient ratios.

Clean Bill: Health Care Industry Raises LA’s Office Market Fever | The demand from the health care industry has reached new heights and is expected to continue growing. Providers have so far made up about 10 percent of the leasing activity in the office market throughout the country in 2019, and the 13 percent jump in transactions shows the submarket is growing almost twice as fast as other commercial investments, according to Marcus & Millichap. A significant portion of that healthy activity is in L.A., which is seeing big sales and development in the pipeline in areas like the San Fernando Valley, Downtown L.A., Pasadena, and the South Bay. For example, Meridian, a medical office developer and owner, announced this week that it sold the 115,000-square-foot Cotton Medical Center in Pasadena to Healthcare Realty Trust, a publicly traded REIT that also owns and develops outpatient facilities. R.J. Sommerdyke, Meridian’s vice president of acquisitions, said the firm is also currently developing about 500,000 square feet of new space, and has more than 500,000 square feet in its pipeline.

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