Category: Editorial

Healthcare’s Hidden Crisis: AI’s Essential Role in Combating Drug Diversion

Steve Mok

By Steve Mok, PharmD, MBA, BCPS, BCIDP, Manager of Pharmacy Services and Fellowship Director for Clinical Surveillance and Compliance, Wolters Kluwer, Health.

Each year, an estimated 37,000 diversion incidents occur in U.S. healthcare facilities, which likely understates the true extent of this problem. These incidents are not just numbers; they represent compromised patient safety, colleagues facing substance use disorder and organizations exposed to significant financial and reputational risks.

Resource Gaps and Hidden Risks

Over recent years, hospitals have responded to these cases and the perceived risk by expanding their diversion teams. Today, most large facilities employ three or more full-time staff dedicated to diversion programs, a notable improvement from 2023, when most reported only one or fewer staff member being engaged in that work. However, despite this increased investment, confidence in these programs remains low. Just 32% of survey participants say they feel “very confident” in their current approaches.

This confidence gap stems from the limitations of traditional detection methods. Routine audits (71%), dispensing reports (68%), and inventory checks (65%) – which are the most used detection methods – require significant time and attention, yet still leave considerable vulnerabilities. As one respondent noted, “Automated dispensing systems and electronic tracking can create a false sense of security, but shrewd diverters often find ways to bypass, especially in high-volume environments.”

The Opportunity with AI

With their ability to parse through more data than would ever be humanly possible, artificial intelligence and machine learning offer a path forward. These technologies can analyze patterns across large data sets in seconds, identifying suspicious behaviors that would take clinical teams days to uncover, if they are found at all. Despite this, fewer than 38% of healthcare organizations have implemented AI tools for diversion detection, with adoption rates even lower in smaller hospitals (32%) compared to larger institutions (48%).

This technological gap creates disparities in patient and staff safety, and organizations recognize AI could help. While 76% of respondents express interest in AI solutions, several barriers remain: lack of technical expertise (29.6%), insufficient leadership buy-in (27.2%), budget constraints (19.2%), and inadequate staffing (18.4%). Smaller hospitals, in particular, face greater obstacles due to their limited personnel and financial resources, placing their patients and staff at increased risk.

The Need for Collaboration & Culture Change

Beyond leaning on the power of technology, effective diversion prevention requires collaboration across departments. While pharmacy and nursing teams typically participate in diversion programs, other critical stakeholders remain underrepresented. Only about one-third of respondents report engagement from anesthesiology, even though providers have frequent access to controlled substances. Human resources is similarly involved in just 20% of programs, despite the department’s critical role in prevention training and rehabilitation.

Organizational culture also plays a significant role in diversion prevention. Survey respondents noted a “culture of silence” around this topic that enables diversion to continue unchecked. As one participant explained, reluctance to report suspected diversion often stems from fear of retaliation, concerns about harming a colleague’s career, or the belief that it is not their responsibility. This highlights the need for programs that combine advanced technology with cultural change—fostering accountability and empowering staff to report concerns without fear.

The Urgency for Action

For those still weighing the decision, consider the benefits: tasks that currently absorb your diversion team’s time – manual audits, report reviews and investigations – could be automated, continuous and more accurate. Teams could shift their focus from data review to addressing diversion cases, supporting colleagues in need, spending more time at the bedside and strengthening prevention programs.

Working with hospitals across the country, I have seen firsthand how drug diversion threatens patient care and staff safety. The challenge calls for a new standard—one that leverages both human insight and the precision of AI. For hospital and pharmacy leaders, the question is not whether you can afford to adopt AI-powered diversion detection. With patient lives, regulatory compliance, and your institution’s reputation at stake, the real question is: Can you afford not to?

New AMGA Survey Notes Significant Gains in Physician Compensation

The newly published AMGA 2025 Medical Group Compensation and Productivity Survey reveals substantial increases in compensation for various clinical specialties in 2024. The results of this year’s survey show a 4.9% compensation increase across the entire dataset.

This comprehensive analysis included data from over 184,000 providers across nearly 500 medical groups, encompassing almost 200 physicians, advanced practice clinicians (APCs), and other provider specialties. The survey is based on 2024 calendar year data.

Participating healthcare organizations reported significant compensation increases for most specialties. Primary care specialties led the way with a 5.7% increase, followed by increases for medical specialties at 4.0%, for surgical specialties at 3.7%, for radiology, anesthesiology, and pathology specialties at 5.1%, and for APCs at 4.3%.

Weighted Average Year-0ver-Year Change

Compensation:  Median Change

2025

2024

2023

2022

Overall

4.9%

5.3%

3.5%

3.7%

Primary Care

5.7%

3.6%

6.0%

3.0%

Medical Specialties

4.0%

5.2%

1.2%

4.1%

Surgical Specialties

3.7%

5.3%

2.1%

3.9%

Radiology/Anesthesiology/Pathology

5.1%

5.8%

1.0%

3.8%

APCs (NP and PA only)

4.3%

5.4%

5.7%

3.7%

After years of fluctuation stemming from Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule changes in 2021 and the post-COVID recovery, productivity appears to be stabilizing across all specialties. Work relative value units (wRVUs) saw a relatively modest average increase of 1.5% overall in 2024. Increases in wRVUs often correlate to an increase in patient visits over the same period, which grew on average by 2.3%. In addition to visits, provider productivity can be influenced by many other factors affecting healthcare today, such as staffing levels and patient demand, effects of provider shortages on the current provider workforce, and increased utilization of APCs and team-based care models.

Weighted Average Year-Over-Year Change

wRVUs:  Median Change

2025

2024

2023

2022

Overall

1.5%

5.2%

2.9%

18.3%

Primary Care

1.9%

5.0%

3.7%

24.1%

Medical Specialties

3.2%

5.2%

1.7%

14.7%

Surgical Specialties

1.1%

4.8%

1.5%

11.8%

Radiology/Anesthesiology/Pathology

1.8%

5.8%

3.1%

0.2%

APCs

-1.0%

6.2%

4.6%

29.7%

With compensation gains outpacing the growth in productivity, providers experienced a 3.2% increase overall in the compensation-per-work RVU ratio. This increase represents the largest growth in the ratio since the COVID-19 pandemic, which flattened in the period following the pandemic. Before COVID-19, the typical year-over-year increase in the overall weighted average compensation-per-wRVU ratio was consistently between +2% and +3%.

 Top Specialty Results by Key Metric

Primary Care

2024-2025 AMGA Median Change

Specialty

Compensation

Work RVUs

Comp / wRVUs

2025

2024

% Change

2025

2024

% Change

2025

2024

% Change

Primary Care

5.7%

1.9%

3.0%

Family Medicine

$330,216

$312,627

5.6%

6,342

6,165

2.9%

$51.66

$50.02

3.3%

Internal Medicine

$347,750

$329,527

5.5%

6,195

6,056

2.3%

$55.62

$54.40

2.2%

Pediatrics – General

$295,248

$279,490

5.6%

6,036

6,031

0.1%

$49.72

$48.28

3.0%

Primary Care Rollup

(Top Three Only)

$329,780

$311,666

5.8%

6,239

6,108

2.1%

$52.53

$50.78

3.4%

In a rollup of the top three specialties in primary care (family medicine, internal medicine, and pediatrics – general), median compensation changed from $311,666 in the 2024 Survey to $329,780 in the 2025 Survey, an increase of 5.8%. Productivity increased at a rate of 2.1% (6,108 wRVUs in 2024 to 6,239 wRVUs in 2025), resulting in a compensation-per-wRVU ratio increase of 3.4%.

 Medical Specialties (Excluding Hospitalists)

2024-2025 AMGA Median Change

Specialty

Compensation

Work RVUs

Comp / wRVUs

2025

2024

% Change

2025

2024

% Change

2025

2024

% Change

Medical Specialties

4.0%

3.2%

1.4%

Cardiology –

General (Non-Invasive)

$615,621

$595,827

3.3%

9,274

9,010

2.9%

$66.80

$65.52

2.0%

Gastroenterology

$633,422

$603,157

5.0%

9,008

8,868

1.6%

$70.47

$67.93

3.7%

Hematology and

Medical Oncology

$556,750

$533,402

4.4%

5,868

5,917

-0.8%

$97.32

$94.86

2.6%

Medical Specialty Rollup

(Top Three Only)

$516,448

$492,480

4.9%

6,687

6,493

3.0%

$74.63

$74.24

0.5%

In a rollup of the top three medical specialties, which include more than 2,000 providers per specialty, the median compensation increase of 4.9% outpaced the 3.0% change in wRVUs.

 Hospitalist Specialties

2024-2025 AMGA Median Change

Specialty

Compensation

Work RVUs

Comp / wRVUs

2025

2024

% Change

2025

2024

% Change

2025

2024

% Change

Hospitalist –

Internal Medicine

$343,143

$335,111

2.4%

4,868

4,607

5.7%

$72.82

$73.80

-1.3%

Hospitalist – Pediatrics

$258,510

$240,634

7.4%

2,578

2,558

0.8%

$97.59

$94.89

2.8%

Hospitalist –

Family Medicine

$386,892

$354,902

9.0%

5,524

4,961

11.3%

$74.59

$73.07

2.1%

Hospitalist Specialty Rollup (Top Three Only)

$339,866

$331,422

2.5%

4,761

4,500

5.8%

$74.00

$74.72

-1.0%

Unlike other medical specialties, hospitalist compensation grew a moderate 2.5%, while productivity saw a greater increase of 5.8%. With productivity growth outpacing compensation, the change led to a 1.0% decrease in the compensation-per-wRVU ratio, a notable contrast to other specialties.

Fred Horton, president of AMGA Consulting, offered the following insight: “While this decrease in the compensation-per-wRVU may seem insignificant, it may also be an indicator that groups are setting more specific work expectations for hospitalists, which indirectly is resulting in higher levels of wRVUs. Interest in annual patient-facing expectations for hospitalists and other shift-based specialties has grown over the past several years, with current survey annual expectations for hospitalists at 2,040 hours annually at median, with a median length of shift at 12 hours.”

Surgical Specialties

2024-2025 AMGA Median Change

Specialty

Compensation

Work RVUs

Comp / wRVUs

2025

2024

% Change

2025

2024

% Change

2025

2024

% Change

Surgical Specialties

3.7%

1.1%

2.9%

OB/GYN – General

$406,633

$396,300

2.6%

7,629

7,505

1.7%

$55.84

$54.62

2.2%

General Surgery

$507,198

$494,287

2.6%

6,917

6,959

-0.6%

$73.82

$71.58

3.1%

Orthopedic Surgery

$748,799

$723,421

3.5%

9,915

9,750

1.7%

$78.00

$76.81

1.5%

Surgical Specialty Rollup

(Top Three Only)

$476,355

$461,309

3.3%

7,724

7,637

1.1%

$73.77

$73.27

0.7%

For the top surgical specialties, compensation and productivity increased 3.3% and 1.1%, respectively, with compensation per wRVU growth at 0.7%.

 Advanced Practice Clinicians (APCs)

2024-2025 AMGA Median Change

Specialty

Compensation

Work RVUs

Comp / wRVUs

2025

2024

% Change

2025

2024

% Change

2025

2024

% Change

APCs

4.3%

-1.0%

6.1%

Nurse Practitioner  –

Primary Care

$142,324

$136,046

4.6%

4,539

4,613

-1.6%

$32.19

$30.48

5.6%

Nurse Practitioner –

Medical Specialty

$141,408

$135,070

4.7%

2,644

2,549

3.7%

$53.09

$51.80

2.5%

Nurse Practitioner –

Surgical Specialty

$139,411

$133,339

4.6%

2,179

2,205

-1.2%

$64.16

$59.44

7.9%

Physician Assistant –

Primary Care

$154,818

$148,430

4.3%

4,959

4,900

1.2%

$31.83

$31.42

1.3%

Physician Assistant – Medical

$148,429

$138,802

6.9%

2,808

2,850

-1.5%

$52.54

$48.60

8.1%

Physician Assistant – Surgical

$150,326

$149,628

0.5%

1,760

1,953

-9.9%

$85.65

$74.12

15.6%

For APCs, compensation increased across all specialties, while there was only a marginal change in productivity (actually decreasing 1.0%). What is more interesting is the lackluster correlation between compensation and productivity for APCs.

“As the percentage of APCs to total provider workforce increases, health systems and medical groups are beginning to assess their approaches to compensation to ensure their plans’ philosophy, compensation plan mechanics and their care models are in alignment,” commented Mike Coppola, MBA, chief operating officer of AMGA Consulting.

Additional Survey Insights

Net Collections

The AMGA 2025 Medical Group Compensation and Productivity Survey also includes professional net collections by individual provider, which increased 5.9% this year within primary care, medical, and surgical specialties. This past year (2024) was a tumultuous time for medical groups navigating a complex payment system. While initially decreasing the CMS conversion rate for Medicare reimbursement to 3.4%, Congressional intervention added back 2.9%, resulting in a less dramatic decrease. The initial decrease, however, forced medical groups and health systems to examine various tactics to mitigate the impact, including renegotiation of non-government contracts.

“In today’s highly challenging healthcare provider marketplace, medical groups continue to feel inflationary pressure as they navigate rising costs,” stated Coppola. “The limited growth in net collections combined with increasing compensation has created a scenario where over the past eight years (2017-2025 survey years), the average annual compensation change for top specialties outpaces the annual change in collections.” 

Physician enterprises today grapple with numerous factors affecting both provider productivity and compensation. The 2025 AMGA survey results clearly show compensation growth consistent with an industry facing a significant shortage of providers. Medical groups are attempting to balance their compensation strategies to align with organizational shifts toward value-based care, experimenting with team-based care and other alternative models, though adoption varies across the market.

At the same time, expectations around provider patient-facing hours, patient/panel volume, and annual clinical expectations are becoming more refined. Coppola commented, “Amid these evolving dynamics, one constant remains: We expect to continue to see strong demand for provider talent across many physician and APC specialties. In our opinion, this trend will continue to lead to analogous compensation increases for providers.”

“AMGA’s survey data is invaluable as organizations navigate the diverse, and often competing, priorities within the provider enterprise,” noted Horton.  “Without a solid understanding of these data, deeper insights, and emerging trends, it is virtually impossible to effectively manage competitive compensation levels, align provider compensation plans, standardize practices, design incentives, drive value, combat provider burnout, and meet industry-standard expectations. This year’s survey offers a wealth of information to help you apply these data and insights to create alignment within your organization.”

About the Survey

The 38th edition of the AMGA Medical Group Compensation and Productivity Survey contains data across nearly 500 medical groups, representing over 184,500 providers from almost 200 physician, advanced practice clinician, and other provider specialties. To learn more and purchase the survey, visit AMGA Consulting’s website.

These Hospitals Are Failing on Safety: The States Not Meeting Hospital Safety Standards

New research has revealed thestates with the safest and least safest hospitals.

Personal injury attorneys at Phillips Law Firm have analyzed the safety grades given to hospitals around the country in the fall of 2024 to determine where the safest medical care is given, based on the percentage of “A” graded hospitals in the area, which is the highest possible rating referring to hospital safety.

In first place with the safest hospitals in the US is Utah. 60.70% of the hospitals in the state have received an “A” grade for safety.

Virginia ranks second, where 50.70% of hospitals have been given an “A” grade and are safe for patients seeking care.

50% of hospitals in Connecticut have been given an “A” grade for safety, placing the state third in the ranking.

North Carolina is in fourth place, where 46.70% of hospitals have received an “A” grade and are safe for patients in the area.

In New Jersey, 46.30% of hospitals have been given an “A” grade, placing the state fifth.

The states with the safest hospitals

Rank State Percentage of Grade A Hospitals
1 Utah 60.70%
2 Virginia 57.70%
3 Connecticut 50.00%
4 North Carolina 46.70%
5 New Jersey 46.30%
6 California 44.90%
7 Rhode Island 44.40%
8 Idaho 42.90%
9 Pennsylvania 41.20%
10 Colorado 40.40%
10 South Carolina 40.40%

However, not all hospitals in the US are as safe.

Iowa, North Dakota, South Dakota, and Vermont are tied as the states with the least safe hospitals; 0% of hospitals in all four states have an “A” grade for safety.

West Virginia places second with 4.50% of its hospitals holding an “A” grade for safety.

New Mexico is next in third place, with 5.60% of hospitals in the state having an “A” grade.

Only 6.70% of hospitals in Alabama have an “A” grade, making it the fourth least safe state for hospital treatment.

The fifth least safe state for hospitals is Hawaii, where 8.30% of hospitals have been given an “A” grade.

The states with the least safe hospitals

Rank State Percentage of Grade A Hospitals
1 Iowa 0.00%
1 North Dakota 0.00%
1 South Dakota 0.00%
1 Vermont 0.00%
2 West Virginia 4.50%
3 New Mexico 5.60%
4 Alabama 6.70%
5 Hawaii 8.30%
6 Wyoming 11.10%
7 Minnesota 11.40%
8 Oregon 15.20%
9 Mississippi 16.20%
10 Arkansas 20.00%
10 Nebraska 20.00%
10 Missouri 20.30%

Phillips Law Firm noted:

“It’s very unsettling to see how few of the 50 states have hospitals with an “A” grade for safety. Receiving adequate healthcare is crucial, especially since, for many, it can range from moderately costly to financially crippling.

“However, it is useful to know where hospitals in your area rank, and it is crucial that you receive the healthcare you need and deserve. The study highlights which states could benefit from more funding to ease pressure on medical staff and to improve care for patients.”

What Rehab Therapists Need to Know About the Rise in CMS and Commercial Audits

John Wallace

By John Wallace, PT, MS, FAPTA, chief compliance officer, WebPT.

Federal audits targeting Centers for Medicare & Medicaid Services (CMS) reimbursements are intensifying, and rehab therapists are already feeling the impact. In the wake of public announcements about increased efforts to eliminate fraud, waste, and abuse in federal healthcare programs, both Medicare and commercial payers have significantly ramped up their auditing activities.

Historically, audits of this kind disproportionately affected large practices. Today, however, even small and mid-sized clinics are receiving record requests from both CMS and commercial insurers. For providers billing Medicare or Medicaid—even those with a long history of compliance—this shift signals the need for heightened awareness, tighter documentation, and proactive internal oversight.

The Changing Landscape of Rehab Audits

The rise in CMS audits is not occurring in isolation. As Medicare strengthens its oversight through contractors like Medicare Administrative Contractors (MACs) and program integrity auditors, commercial payers are quickly following suit. 

While CMS is transparent in publishing documentation expectations and typically approaches audits as educational, commercial payers often take a more punitive stance. Some conduct takeback audits based on small samples, then extrapolate error rates across years of claims to justify large recoupment demands.

This dynamic poses an especially difficult challenge for smaller practices. Commercial insurers, despite often paying significantly less than Medicare (e.g., sometimes 10% to 40% lower), are applying similar levels of scrutiny. And they’re not offering education. They’re demanding repayment.

Where Rehab Providers Are Most Vulnerable

The most frequent audit failures do not stem from fraud, but from insufficient or inconsistent documentation. Many rehab therapists rely heavily on electronic medical records (EMRs) to generate compliant records, but EMR systems alone cannot ensure accuracy. While structured fields and templates are helpful, providers must still input the correct clinical details to meet payer requirements.

One of the biggest vulnerabilities is the lack of regular internal compliance review. Large organizations may employ dedicated compliance staff, but small and medium-sized practices often operate without any formal chart review process. Unfortunately, this reactive model leaves providers exposed. Audits arrive without warning, and without a clear understanding of where documentation falls short, even well-meaning clinics may struggle to defend their claims.

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NeuroEM Therapeutics Closes Initial Rounds in $5 Million Equity Raise to Commercialize Drug-free Alzheimer’s Treatment

NeuroEM Therapeutics, an award-winning clinical-stage biotechnology research company pioneering the use of radio frequencies to reverse Alzheimer’s disease, has closed initial rounds totaling $1.33 million of a $5 million equity raise with BlueLake.vc.

The Series A round supports continued progress toward commercialization of NeuroEM’s Transcranial Electromagnetic Treatment (TEMT-RF) to prevent and treat cognitive decline caused by aging or Alzheimer’s and other neurodegenerative diseases.

Chuck Papageorgiou

“BlueLake’s support demonstrates the importance of maintaining our momentum in the execution of key clinical, regulatory, and commercial milestones on our journey toward a safe, effective, drug-free treatment for Alzheimer’s dementia and other neurodegenerative diseases,” says Chuck Papageorgiou, CEO of NeuroEM Therapeutics. “It fuels the tireless efforts of our researchers, clinicians, engineers, and the entire NeuroEM team to restore the hope and dignity Alzheimer’s disease has already stolen from millions and to one day prevent millions more from facing this devastating diagnosis.”

The equity round is led by BlueLake Partner Jamie Rutledge, who also joins the NeuroEM Board of Directors. Rutledge focuses on early-stage investments in breakthrough technologies at BlueLake and is a seasoned technology investor and executive with deep expertise in strategic investment and innovation across the medical technology and consumer electronics sectors.

He brings more than 25 years of experience to NeuroEM, including senior leadership roles at Dyson and Lenovo. He previously led Lenovo’s Strategic Venture Capital and Open Innovation initiatives and directed technology scouting and strategic investments at Dyson.

“NeuroEM’s pioneering, non-invasive approach to treating and preventing Alzheimer’s represents exactly the kind of patented, deep tech innovation we champion at BlueLake—transformative, defensible, and grounded in scientific rigor. This approach to drug-free treatment and prevention of Alzheimer’s holds tremendous promise in tackling a disease that has eluded effective solutions for decades,” said Rutledge. “We’re proud to support the advancement of this groundbreaking technology, and I’m personally honored to help guide NeuroEM as it brings innovative, non-invasive therapies to the forefront of neurodegenerative care.”

Adds Papageorgiou, “Jamie’s background in radio frequency systems, embedded devices, and product development aligns closely with our core technology, and his strategic insight will be a valuable asset as NeuroEM moves toward commercialization and broader market engagement.”

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AI is Changing Patient Search and Medical Practices Need To Evolve

Evan Steele

By Evan Steele, founder and CEO, rater8.

The way patients search for care is undergoing a seismic shift. Traditional search results, those familiar blue links we’re all familiar with, are giving way to answers generated by artificial intelligence (AI).

Tools like Google’s Search Generative Experience (SGE), ChatGPT, and Perplexity are now delivering curated, conversational responses that quickly guide patients to providers — and away from your website. This shift has major implications for how healthcare practices get discovered, and trusted, by new patients online.

Why This Matters

Healthcare is one of the industries most affected by these changes, and the implications are real: websites are seeing less organic traffic, ad costs are rising, and providers with weak online reputations are falling off the map entirely.

In the past, patients might have searched “best orthopedic surgeon near me” and combed through the local listings. Today, they’re more likely to be conversational with their search queries and ask questions such as, “Who’s the best orthopedic surgeon in Austin accepting new patients?”

AI responds with a single answer, not a list of options. And the practices that show up? They’re the ones with a strong online presence, detailed reviews, and structured content that’s easy for AI to parse through.

Moreover, Google is now citing its own reviews in AI Overviews, alongside third-party listings like Healthgrades and Vitals. This change signals a broader shift: Google is casting a wider net to populate AI-generated results, which means practices must maintain a presence across all major review platforms. Visibility is no longer just about ranking high on Google — it’s about being referenced in the sources that AI has already been trained to trust.

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Streamlining Hospital Discharge with Technology: A Strategic Imperative for Reducing Readmissions

Judit Sharon

By Judit Sharon, CEO and founder, OnPage Corporation.

For healthcare providers, IT professionals, and hospital executives, the discharge process is a critical juncture in a patient’s care journey. When executed effectively, it ensures continuity of care, reinforces patient understanding, and promotes recovery. When done poorly, it can trigger any number of adverse outcomes—from medication mismanagement and missed follow-ups to costly, avoidable readmissions.

As value-based care models continue to shift incentives toward improved outcomes and lower costs, hospital discharge processes need to improve. Fortunately, reducing readmissions is an achievable goal—and technology can play a pivotal role in making it happen. By modernizing communication, increasing care team collaboration, and giving patients direct access to support after leaving the hospital, healthcare organizations can create a safer, more connected discharge experience.

The Consequences of Inefficient Discharge

Every discharge is a high-stakes handoff. Patients move from a tightly managed hospital environment to home or another care setting where oversight is minimal and resources may be limited. Without clear instructions, seamless coordination, and easy access to care providers, many patients fall through the cracks.

This breakdown in care continuity has measurable consequences. Nearly one in five Medicare patients is readmitted within 30 days because of issues that could have been prevented with better discharge planning or faster follow-up. These readmissions not only impact patient outcomes but also result in financial penalties under CMS’s Hospital Readmissions Reduction Program (HRRP).

For administrators, this isn’t just a clinical problem—it’s a bottom-line issue. Beyond reimbursement losses, readmissions can damage hospital ratings, increase workload for clinical staff, and lower patient satisfaction scores. Addressing the root causes of readmissions is no longer optional; it’s a strategic priority.

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An Automated Solution to Healthcare’s $125 Billion Fax Problem

By Thomas Thatapudi, CIO, AGS Health

In 2018, the head of the Centers for Medicare and Medicaid Services issued a challenge to health IT developers and providers alike to “help make every doctor’s office in America a fax-free zone by 2020.”

The challenge was issued out of frustration with a vital workflow that remains reliant on outdated fax technology. Each year, healthcare providers exchange over 9 billion fax pages, driving an estimated $125 billion in costs across the healthcare system.

The continued reliance on fax technology is a persistent challenge for healthcare, undermining data integrity and operational efficiency. Studies by DirectTrust reveal alarming statistics: 30% of tests must be re-ordered due to lost faxes, and 25% fail to arrive on time for patient visits. Additionally, integrating faxes into health systems often demands manual indexing—an expensive and time-intensive task many organizations can ill afford.

Fortunately, automation offers a solution. Machine Learning and Generative AI are particularly adept at handling repetitive tasks such as fax indexing. While achieving perfect accuracy from the outset is unlikely, pairing AI-driven Digital Workers with human oversight ensures exceptions are managed effectively. Over time, as AI systems learn and adapt, they can assume more complex responsibilities.

To succeed, this model requires a carefully designed workflow that balances human expertise with AI capabilities to meet quality, timeliness, and accuracy standards.

Building the Digital Workforce

A successful hybrid fax indexing strategy relies on a carefully designed digital workflow model that effectively coordinates efforts between human staff and Digital Workers. The process begins with identifying the necessary technologies, which is best accomplished by observing human indexers to gain a comprehensive understanding of their workflows and unique requirements. This insight informs both implementation planning and feasibility testing.

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