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Potential of GenAI in Healthcare

Generative AI Adoption Accelerates in Healthcare, Survey Reveals

Healthcare leaders are increasingly embracing generative AI to enhance administrative efficiency and clinical productivity, according to a new McKinsey & Company survey. The latest findings, based on Q4 2024 responses from 150 executives across payers, health systems, and healthcare technology firms, highlight rapid adoption and shifting investment priorities. Key Survey Insights Growing Adoption of Gen AI Partnerships Drive Implementation Top Use Cases: Efficiency & Engagement ROI Expectations Are High Strategic Recommendations McKinsey’s report emphasizes that successful gen AI integration requires: “As generative AI gains momentum, healthcare leaders must position their organizations for long-term success by prioritizing high-impact use cases and strategic partnerships,” the authors noted. The findings underscore generative AI’s expanding role in transforming healthcare operations, with early adopters already seeing measurable benefits. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Analytics tools like Einstein Analytics can identify patterns and trends in patient data, helping healthcare providers optimize workflows and improve the effectiveness of care delivery.

Healthcare Payers Turn to Data Analytics for Cost Savings and Improved Outcomes

Facing persistent financial and staffing pressures, healthcare payers are increasingly adopting data analytics platforms to streamline operations, reduce costs, and enhance member outcomes. A new April 2025 report from KLAS Research offers its first evaluation of payer experiences with these solutions, highlighting key vendors and emerging trends. The Growing Role of Data Analytics in Payer Operations With healthcare organizations under constant pressure to improve efficiency and decision-making, data analytics tools provide critical visibility into claims data, utilization patterns, and financial performance. These platforms enable payers to: While KLAS’ research in this space is still evolving, the initial report assesses three leading vendors, with plans to expand coverage as more data becomes available. Key Vendor Performances 1. MedInsight – Best in KLAS 2025 (Score: 85.8) 2. MedeAnalytics (Score: 87.1) 3. Clarify Health Solutions 4. Salesforce Health Cloud Looking Ahead: Expanding the Vendor Landscape Additional players like CareJourney (acquired by Arcadia in 2024), Cedar Gate Technologies, and Cognizant are expected to be evaluated in future KLAS reports as more performance data emerges. The Bottom Line As payers seek greater efficiency and data-driven decision-making, analytics platforms are becoming indispensable. While MedInsight and MedeAnalytics lead in early adoption, the competitive landscape is still evolving—making future KLAS insights critical for payer organizations evaluating their options. Next Steps: With the right analytics partner, payers can unlock cost savings, operational efficiencies, and better member outcomes—key priorities in today’s challenging healthcare environment. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Salesforce and Healthcare

Aligning Payers and Providers for True Patient-Centered Care

Patient-centered care is an approach to healthcare that prioritizes the patient’s needs, values, and preferences. It involves treating patients with respect, dignity, and compassion, and ensuring that they are actively involved in their own healthcare decisions. Key Principles of Patient-Centered Care: Benefits of Patient-Centered Care: Improved patient satisfaction and adherence to treatment plans, Enhanced health outcomes, Reduced healthcare costs, and Stronger patient-provider relationships. Examples of Patient-Centered Care: Patient-centered care is a holistic approach to healthcare that focuses on the patient as an individual. By empowering patients and respecting their needs, it aims to improve their health and overall well-being. The Shared Vision vs. Systemic Barriers All healthcare stakeholders agree on one fundamental principle: care should revolve around patients’ needs and preferences. Yet despite this shared goal, competing priorities between payers and providers often create friction that undermines patient-centered care delivery. Theresa Dreyer of the Health Care Transformation Task Force observes: “Payers and providers both want patients to receive accessible, appropriate care. But the current system’s structure frequently puts these groups at odds.” Defining Patient-Centered Care At its core, patient-centered care means: “Imagine the care you’d want for your own family members,” Dreyer suggests. “That’s the standard we should apply across healthcare.” The Fee-for-Service Roadblock The dominant fee-for-service (FFS) model creates inherent conflicts: “FFS turns cost containment into a zero-sum negotiation,” Dreyer explains. “Value-based models offer a collaborative alternative.” Value-Based Care as the Unifying Framework 1. Quality-Focused Contracting 2. Streamlined Prior Authorization 3. Holistic Care Integration The Preventive Care Imperative The long-term nature of prevention creates systemic challenges: “Diabetes management today prevents kidney failure tomorrow,” Dreyer notes. “We need payment models that reward this foresight.” Building Collaborative Solutions For Payers: For Providers: Joint Opportunities: The Path Forward The healthcare industry stands at an inflection point. By embracing value-based models that: Payers and providers can transform their relationship from adversarial to collaborative—with patients as the ultimate beneficiaries. As Dreyer concludes: “Beyond the contracting details and quality metrics, we must remember our shared purpose: helping people achieve and maintain health. When we center that mission, the rest follows.” Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Agentforce to the Team

Salesforce Unveils AI-Powered Agentforce for Health

Salesforce Unveils AI-Powered Agentforce for Health to Streamline Healthcare Operations Salesforce is expanding its AI capabilities in healthcare with the launch of Agentforce for Health, a library of ready-made, autonomous AI tools designed to tackle time-consuming administrative tasks for providers, payers, and public health organizations. Unlike traditional AI assistants that require constant human input, Agentforce for Health leverages agentic AI, which can make independent decisions and operate with minimal intervention. This shift could be a game-changer for an industry grappling with labor shortages, burnout, and rising administrative costs—which McKinsey estimates at $1 trillion annually in the U.S. alone. How Agentforce for Health Works The new solution offers a range of AI-powered capabilities, including: By automating these processes, healthcare teams estimate they could save up to 10 hours per week, according to a Salesforce survey released alongside the product announcement. Salesforce’s AI Edge in Healthcare While tech giants like Google (Agentspace) and Microsoft are also investing in AI-driven healthcare solutions, Salesforce differentiates itself through its deep integration with its CRM platform. This allows Agentforce for Health to not only automate tasks but also seamlessly enhance patient engagement and care coordination. Additionally, Salesforce’s Einstein Copilot Health Actions, a conversational AI assistant launched in April, complements Agentforce by enabling interactive AI-driven decision-making for healthcare teams. Availability & Future Rollout Salesforce is rolling out Agentforce for Health’s AI skills through September for clients using its cloud platform. As AI adoption accelerates in healthcare, Salesforce is positioning itself as a key player in helping the industry reduce administrative burdens, improve efficiency, and enhance patient outcomes. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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AI-Driven Healthcare

The Future of Healthcare is Digital

Transforming Healthcare with Salesforce Health Cloud In our rapidly evolving healthcare world, digital transformation is no longer optional—it’s essential. Healthcare organizations must leverage innovative solutions to improve patient outcomes, streamline operations, and drive financial growth. Salesforce Health Cloud empowers providers, payers, and life sciences companies to deliver personalized, connected, and data-driven care. The Urgency of Digital Transformation in Healthcare Healthcare organizations face increasing pressure from regulatory requirements, patient expectations for seamless digital experiences, and operational inefficiencies. Traditional systems are often fragmented, making it difficult to provide a unified patient experience. Salesforce Health Cloud addresses these challenges by enhancing communication, centralizing data, and optimizing workflows. Key Benefits of Salesforce Health Cloud ✅ Enhanced Patient EngagementPatients expect convenience, transparency, and personalization. Health Cloud delivers seamless communication through patient portals, automated reminders, and AI-driven insights—leading to higher engagement and improved adherence to treatment plans. ✅ 360-Degree Patient ViewBy integrating data from electronic health records (EHRs), wearable devices, and other sources, Health Cloud provides a unified patient profile. This empowers providers and payers to make data-driven decisions that improve both clinical and business outcomes. ✅ Operational Efficiency & Cost ReductionHealth Cloud automates workflows, reduces redundancies, and improves productivity by integrating clinical, operational, and administrative processes. Real-time collaboration enhances care coordination across teams and organizations. ✅ AI-Powered Insights for Better Decision-MakingWith AI-driven analytics and predictive insights, healthcare organizations can identify at-risk populations, optimize resource allocation, and enhance population health management. Salesforce Einstein AI helps forecast trends and personalize care recommendations. ✅ Interoperability & Regulatory ComplianceNavigating complex healthcare regulations is easier with Health Cloud’s secure architecture, ensuring compliance while enabling seamless data exchange between systems and stakeholders. Why Healthcare Organizations Should Adopt Health Cloud Investing in digital transformation provides a competitive advantage by improving patient satisfaction, reducing operational costs, and driving better health outcomes. Salesforce Health Cloud enables organizations to future-proof their operations, boost revenue, and implement a seamless, value-based care model. Use Cases of Salesforce Health Cloud 🏥 Health Insurers – Improve member engagement, claims processing, and care management to enhance efficiency and reduce costs. 🏥 Hospitals & Health Systems – Streamline care coordination, minimize readmissions, and enhance patient experiences with personalized care plans. 🏥 Home Healthcare & Telemedicine – Enable remote patient monitoring and virtual care, improving accessibility while reducing hospital visits. 🏥 Life Sciences Companies – Accelerate drug development, streamline clinical trials, and enhance collaboration with providers and patients. The Future of Healthcare is Digital Salesforce Health Cloud is at the forefront of healthcare’s digital revolution. By leveraging AI, automation, and seamless integrations, healthcare leaders can improve patient experiences, drive operational efficiency, and ensure long-term success. Now is the time to embrace a data-driven approach to healthcare management. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Healthcare Cloud Computing

Member Experience in Healthcare

Member Experience in Healthcare: Why It Matters for Payers In today’s consumer-driven healthcare market, member experience is no longer a nice-to-have—it’s a competitive necessity for health payers. With rising consumer expectations and fierce competition during open enrollment, payers must prioritize seamless, digital-first interactions to attract, retain, and satisfy members—while also protecting their bottom line. What Is Member Experience for Health Payers? Member experience refers to how health plan beneficiaries interact with their insurers—from finding providers and filing claims to accessing customer support and digital tools. A positive experience means:✔ Ease of use (intuitive portals, quick claims processing)✔ Transparency (clear benefits, no surprise denials)✔ Responsive support (fast resolutions via phone, chat, or AI)✔ Personalized engagement (tailored recommendations, proactive outreach) Poor experiences, on the other hand, lead to frustration, distrust, and member churn. Why Member Experience Matters More Than Ever 1. Consumers Are Voting With Their Wallets 2. Payers Lag Behind Other Industries 3. Better Experience = Better Business Outcomes Investing in member experience drives:✅ Higher retention & acquisition (loyalty = lower marketing costs)✅ Reduced call center volume (AI & self-service cut costs)✅ Fewer claim disputes & appeals (transparency builds trust) What Do Members Actually Want? According to Accenture & Bain, top member demands include:🔹 Easy access to plan information (no digging through PDFs)🔹 Fast, omnichannel support (chat, phone, portal—all synced)🔹 Frictionless digital tools (mobile apps, AI chatbots, e-billing)🔹 Transparent claims & approvals (no surprise denials) Members who rate their plan as “very easy to use” are 2X more likely to stay. How Can Payers Improve Member Experience? 1. Boost Digital Maturity 2. Fix Pain Points First 3. Measure What Matters Key KPIs to track:📊 Net Promoter Score (NPS) – Would members recommend you?📊 First Call Resolution (FCR) – Are issues solved quickly?📊 Claims Processing Time – How fast are claims paid?📊 Retention Rate – Are members renewing? The Bottom Line Health payers can no longer afford slow, confusing, or frustrating member experiences. With consumer expectations rising, the winners will be those who: The future belongs to payers that treat members like valued customers—not just policyholders. “Member experience isn’t just about satisfaction—it’s about loyalty, retention, and growth. Payers that get it right will outperform those stuck in legacy models.”—Bain & Company, 2024 Ready to transform your member experience? Contact Tectonic, your health and life sciences partner. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Autonomous AI Service Agents

How Do Autonomous Agents Work?

Autonomous agents like Florida Bay’s understand and respond to requests, and then act without human intervention. Give the agent a goal, and it generates tasks for itself, completes them, and moves on to the next one until the goal is achieved. Unlike traditional chatbots that follow predefined rules, autonomous agents operate in dynamic environments, making them perfect for complex tasks in customer service, marketing, commerce, sales, and more. While autonomous agents don’t need human help to complete their tasks, they still need you to describe the ideal goals and main objectives you want to achieve. Once in action, the agent can save your business significant time and resources and allow you to focus on improving the overall customer experience and driving growth–just like at Florida Bay. You might think setting up an agent takes a lot of time, but autonomous agents‌ require less time to build compared with traditional bots. And they can do more when you set them up with the right data and actions. Let’s take a look at the key components that make them effective. Data Data is the foundation of an autonomous agent‘s functionality. It’s what enables an agent to make informed decisions and execute tasks autonomously. At Florida Bay, the concierge agent analyzes opt-in data about the Smith family, including family member profiles, past travel history, and more, to gain a deeper understanding of their preferences. With these insights, the agent can personalize every aspect of their trip and provide a seamless and enjoyable vacation. Decision-Making When an autonomous agent analyzes data, it uses advanced decision-making algorithms to prioritize and execute tasks efficiently. For the concierge agent at Florida Bay, that means evaluating various options and scenarios to ensure that every decision aligns with the Smith family’s preferences and goals. Action Execution After making data-driven decisions, the agent seamlessly transitions to executing the planned actions. For the concierge agent, those planned actions might be autonomously reserving hotel rooms, arranging transportation, and more. This not only enhances the customer experience but also allows the business to save an immense amount of time and focus on other critical tasks that provide even better customer service. Learning and Adaptation Over time, the agent continuously learns from each interaction and adapts to improve future performance. It analyzes feedback and outcomes to refine its algorithms and decision-making processes to better meet the customer’s needs. In addition, autonomous agents are adaptable to various situations and can provide data-driven solutions to simplify and improve efficiency in a wide range of areas. Let’s take a look at that next. Autonomous Agents in Action Autonomous agents are becoming increasingly universal and offer support in a wide range of fields. Here are some industries where they bring significant benefits and support to CRM platforms. Healthcare An autonomous agent can engage with patients, providers, and payers to resolve inquiries, provide summaries, and take action. For example, a patient services agent can answer simple patient questions, help schedule appointments with the best physician, review coverage benefits, generate medical history summaries, and approve care requests. Example: A patient needs to schedule a follow-up appointment with a specialist. They use the healthcare provider’s agent to request the appointment. The autonomous agent checks the availability of the best-suited specialist, confirms the patient’s insurance coverage, and schedules the appointment. The agent also generates a summary of the patient’s medical history and sends it to the specialist in advance. This streamlined process ensures that the patient receives timely care and reduces the administrative burden on healthcare staff. Financial Services Banks can autonomously manage transaction disputes through various channels such as the banking app, SMS, website, or phone. Prebuilt service flows allow agents to file complaints, meet regulatory reporting requirements, verify transaction history, alert merchants, and even issue provisional credits or new cards. These autonomous agents only escalate to a human for final authorizations, saving time and allowing human experts to focus on more complex interactions. Example: A customer notices a fraudulent transaction on their bank statement and reports it through the banking app. The autonomous agent verifies the transaction history, files the complaint, and issues a provisional credit to the customer’s account. The agent also alerts the merchant and schedules a follow-up with a human representative for final authorization. This process, which used to take several days, is now completed within hours, significantly improving customer satisfaction and reducing the workload on human service reps. Insurance Insurance companies can autonomously update coverage, extend better pricing to qualified policyholders, update beneficiaries, schedule and deploy claims adjusters, and even issue claims checks or policy renewals—all without human intervention. Wealth advisors reported that 67% of their daily work is non–value-added administrative work. Autonomous agents can reduce this by planning, scheduling, and summarizing client meetings, drafting client communications, and ensuring compliance by routing communications to the proper licensed supervisors. Example: An insurance policyholder wants to update their beneficiary information. They use the insurance company’s mobile app to make the change. The autonomous agent verifies the policyholder’s identity, updates the beneficiary’s information, and sends a confirmation email. The agent also ensures that the change is compliant with regulatory requirements by routing the communication to a licensed supervisor for a final review. This process, which previously required a phone call and manual processing, is now completed in seconds, freeing up the policyholder’s time and reducing administrative workload. Retail Autonomous agents can share campaign insights, proactively manage customer outreach, and resolve cases for retailers. A personal shopper autonomous agent acts like a digital concierge for online shoppers, using generative AI to help customers on ecommerce sites, chat, or messaging apps like WhatsApp. While basic chatbots only solve predefined questions, autonomous AI agents learn from shoppers’ behavior and preferences and can provide natural language searches, conversational responses, and quick cart additions for instant checkout. Example: A customer is shopping for a new pair of shoes on an ecommerce site. The personal shopper autonomous agent, integrated into the chat feature, engages with the customer and analyzes their past purchases and preferences.

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ai arms race

AI Arms Race

AI Arms Race: Providers Catching Up to Payers in Claims Review The healthcare sector is in the midst of an escalating AI arms race as providers adopt the same artificial intelligence technologies payers are leveraging for claims review. Insurers currently lead this race, using AI to streamline processes such as prior authorizations, but experts predict providers will soon narrow the gap. Insurers’ AI Advantage Leading payers, including UnitedHealth, Humana, and Cigna, have integrated algorithmic decision tools to assess claims and determine coverage eligibility. These technologies allow insurers to flag services that fall outside plan criteria, ostensibly increasing efficiency. This trend is expanding, as evidenced by Blue Shield of California’s announcement of a partnership with Salesforce to pilot claims automation technology in early 2025. The nonprofit insurer claims this initiative will reduce prior authorization decision times from weeks or days to mere seconds, benefiting providers and patients alike. However, provider experiences paint a more contentious picture. Reports from lawmakers and healthcare executives suggest AI-driven claims processes lead to a surge in denials. For example, Providence CFO Greg Hoffman revealed that AI adoption by payers resulted in a 50% increase in underpayments and initial denials over two years, forcing providers to significantly increase manual interventions to resolve claims. A Battle for Balance The imbalance in AI adoption has prompted providers to take action. Experts like Jeffrey Cribbs, a vice president analyst at Gartner, see this as a forced “arms race” in which both sides are continually refining their tools. While payers focus on flagging potential exceptions, providers are working to develop systems for more efficient claims submissions and dispute resolution. Providence’s strategy includes outsourcing revenue cycle management to R1, a 10-year partnership designed to quickly address rising claims denials. Hoffman explained that building equivalent AI systems internally would take years, making partnerships essential for staying competitive in the short term. Collaboration Among Providers On the provider side, executives like Sara Vaezy, EVP and Chief Strategy Officer at Providence, emphasize the need for collaboration. She advocates for coalitions to share data and establish AI standards, which would allow providers to compete more effectively. Panelists at HLTH echoed this sentiment. Amit Phull, Chief Physician Experience Officer at Doximity, argued that AI could eventually “level the playing field” for providers by reducing the time required for claims documentation. Deloitte principal consultant Bill Fera added that AI would allow providers to quickly analyze policies and determine whether a patient qualifies for coverage under plan terms. The Road Ahead Despite the current disparity, experts believe AI will eventually equalize the claims review process. Providers are beginning to invest in tools that will help them handle vast amounts of data efficiently, offering clarity in disputes and cutting down documentation time. “It’s still early innings,” Phull said, “but the technology is going to go a long way toward leveling that playing field.” For now, however, insurers maintain the upper hand. As providers navigate the complexities of AI adoption, partnerships and collaboration may prove critical in ensuring they remain competitive in this rapidly evolving landscape. Like Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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Potential of GenAI in Healthcare

Potential of GenAI in Healthcare

Clinicians spend about 28 hours per week on administrative tasks, mainly clinical documentation and communication. Medical and claims staff reported even higher administrative loads, with 34 and 36 hours spent weekly on tasks like documentation, communication, and prior authorization. Many respondents linked these demands directly to burnout, with 77% of claims staff, 81% of medical staff, and 82% of clinicians citing administrative burdens as significant contributors. Additionally, 78% of payer executives and 85% of provider executives noted that administrative work is a key driver of staffing shortages.

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Value-Based Care Technologies

Value-Based Care Technologies

Essential Technologies for Value-Based Care Success As healthcare providers increasingly adopt value-based care, they must invest in the right technologies and resources to succeed in this model, which incentivizes high-quality, cost-effective care. Value-Based Care Technologies tie reimbursement to care quality, making providers accountable for patient outcomes while providing resources to enhance care. As of 2021, nearly 60% of healthcare payments were already tied to value-based models, according to the Health Care Payment Learning and Action Network (HCP LAN). While partnerships can initiate value-based care, providers must invest in the right technology to fully achieve the intended outcomes. Health Information Exchange (HIE) A robust health information exchange (HIE) is fundamental to value-based care, as it enables providers and payers to access high-quality data seamlessly. HIE allows healthcare professionals to share patients’ medical information electronically across organizations, promoting care coordination by giving providers a comprehensive view of patient needs. For patients, HIE enables more informed involvement in their care by making their health data accessible across specialists, labs, and pharmacies. While joining an HIE may involve new technology investments and workflow adjustments, it ultimately enhances provider access to critical health data. Population Health Management Tools Population health management tools help providers assess health outcomes within groups rather than focusing on individuals alone. These tools aggregate and analyze data, allowing practices to identify high-risk patients and create targeted interventions. This not only enhances health outcomes but can also reduce costs by avoiding expensive treatments. Patient engagement tools, such as telehealth and remote patient monitoring, are essential in population health management, especially for monitoring high-risk patients when in-person care is not feasible. Digital surveys integrated within patient portals can provide insights into social determinants of health, adding a broader context to patient needs. Data Analytics Data analytics transform healthcare data into actionable insights across four types: descriptive, diagnostic, predictive, and prescriptive. Providers can use these analytics to reduce hospital readmissions, predict diseases, and identify chronic illnesses. Data integration and risk stratification capabilities are especially valuable in value-based care, enabling providers to track patient health outcomes effectively and prioritize high-risk cases. Artificial Intelligence & Machine Learning AI and machine learning support many data analytics functions, helping identify patient needs and easing administrative burdens. Given staffing shortages and burnout—reported by 63% of physicians in 2021, according to the American Medical Association (AMA)—AI can automate tasks like documentation, charting, and scheduling, allowing providers to focus more on patient care. Additionally, AI-driven automation in revenue cycle management tasks, such as billing and coding, can reduce the administrative workload associated with value-based care. Price Transparency Technology Price transparency empowers patients to seek cost-effective care, a core principle of value-based models. When providers comply with transparency regulations, patients can better understand their costs and make informed decisions. For providers, leveraging price transparency tools ensures compliance and facilitates partnerships with payers by enabling more effective negotiation, which supports the overall goals of value-based care. As healthcare continues shifting to value-based models, investing in these technologies is critical for providers aiming for long-term success. While these tools rdo equire substantial investment, they are essential for improving patient outcomes, optimizing care quality, and ensuring sustainability in value-based care. When evaluating and choosing healthcare technology tools, contact Tectonic for help. Like1 Related Posts Salesforce OEM AppExchange Expanding its reach beyond CRM, Salesforce.com has launched a new service called AppExchange OEM Edition, aimed at non-CRM service providers. Read more The Salesforce Story In Marc Benioff’s own words How did salesforce.com grow from a start up in a rented apartment into the world’s Read more Salesforce Jigsaw Salesforce.com, a prominent figure in cloud computing, has finalized a deal to acquire Jigsaw, a wiki-style business contact database, for Read more Service Cloud with AI-Driven Intelligence Salesforce Enhances Service Cloud with AI-Driven Intelligence Engine Data science and analytics are rapidly becoming standard features in enterprise applications, Read more

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