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'Gold Card' Programs Offer Limited Prior Auth Relief
'Gold Card' Programs Offer Limited Prior Auth Relief

Medscape

time5 days ago

  • Health
  • Medscape

'Gold Card' Programs Offer Limited Prior Auth Relief

This transcript has been edited for clarity. Gold card programs were introduced as a potential solution to streamline the prior authorization process, allowing physicians with consistently approved requests to bypass certain insurance requirements. However, the results have been disappointing. In Texas, an early adopter of this approach, only 3% of healthcare providers qualified for gold card status. The impact on healthcare delivery is significant; physicians and their staff spend approximately 13 hours weekly on prior authorization documentation, resulting in delayed patient care. Under current requirements, healthcare providers must submit at least five requests for a specific health service over a year, with a 90% approval rate to achieve gold card status. While the concept makes intuitive sense, it raises concerns about equity. Larger medical groups with more resources may navigate the process more successfully than smaller private practices. A recent study of Medicare Advantage insurers revealed limited consensus on which treatments require prior authorization. Only 12% of Medicare spending would have required prior authorization across all studied insurers. The impact extends to patients, too, with two thirds of cancer patients becoming personally involved in authorization processes, leading to decreased trust in the healthcare system overall.

Physicians Identify Top EHR Issues Requiring Immediate Attention: AI-Powered Documentation Automation Emerges as Leading 2026 Priority, Black Book Annual Survey
Physicians Identify Top EHR Issues Requiring Immediate Attention: AI-Powered Documentation Automation Emerges as Leading 2026 Priority, Black Book Annual Survey

Associated Press

time11-07-2025

  • Health
  • Associated Press

Physicians Identify Top EHR Issues Requiring Immediate Attention: AI-Powered Documentation Automation Emerges as Leading 2026 Priority, Black Book Annual Survey

Physicians' urgent call for EHR improvements aims to significantly reduce burnout and enhance clinical workflows NEW YORK CITY, NY / ACCESS Newswire / July 11, 2025 / In the face of escalating clinician burnout rates affecting nearly 55% of hospital-affiliated physicians, urgent improvements in Electronic Health Record (EHR) systems have become paramount, according to the latest Q2-Q3 polling by Black Book Research. The survey polled 274 physicians and healthcare practitioners affiliated with U.S. hospital health systems, asking each participant to identify their single most critical EHR improvement from six key areas to immediately enhance clinical efficiency and patient care delivery. AI-Powered Documentation Automation emerged as the top urgent priority, selected by 37% of respondents. Physicians underscored the transformative potential of intelligent automation, noting that manual clinical documentation consumes up to half of their daily time. Leveraging artificial intelligence to streamline documentation could significantly alleviate workload pressures and enhance clinician satisfaction. The second-highest priority, cited by 26% of participants, is improving Interoperability andSeamless Data Integration. Respondents highlighted ongoing challenges, with 63% experiencing delays or difficulties accessing critical patient information across different systems weekly. Enhanced data-sharing capabilities and compliance with interoperability standards are considered essential to reducing clinical inefficiencies and supporting high-quality care coordination. Clinician-Centric User Experience (UX) Redesign ranked third, chosen by 17% of respondents. Practitioners emphasized the need for intuitive, physician-driven design, with 72% stating current EHR interfaces contribute significantly to workplace frustration and fatigue. Enhanced Clinical Decision Support (CDS) tools, prioritized by 12% of participants, highlight physicians' desire for fewer but more relevant alerts. Mobile and Device-Agnostic Access (7%) underscores growing demand for flexible EHR platforms accessible across various devices, particularly given that 80% of respondents regularly access patient data remotely. Rapid System Responsiveness, selected by 4%, points to frustrations with slow EHR system performance, with 51% of physicians experiencing productivity-impacting lag time or downtime at least monthly. The survey also revealed clear physician expectations of EHR vendors: 78% expect significant system improvements by year-end 2025. 42% expressed willingness to switch vendors if substantial improvements are not delivered within two years. 86% confirmed they had formally communicated these concerns to their EHR vendors, underscoring the urgency of action. 'Physicians have clearly articulated the areas where EHR systems continue to hinder rather than help,' said Doug Brown, Founder of Black Book Research. 'Addressing these top concerns, particularly documentation automation and interoperability, is critical not only to reducing clinician burnout but to ensuring consistent and high-quality patient care. EHR vendors and healthcare IT departments must swiftly respond to these priorities to maintain clinician trust and satisfaction.' Ranked Survey Results: AI-Powered Documentation Automation - 35% Interoperability and Seamless Data Integration - 25% Clinician-Centric User Experience (UX) Redesign - 17% Enhanced Clinical Decision Support (CDS) - 12% Mobile and Device-Agnostic Access - 7% Rapid System Responsiveness - 4% About Black Book Research: Black Book Research is an independent, vendor-agnostic research firm providing insights and analysis based on unbiased, comprehensive market surveys. Utilizing robust methodologies, including flash surveys, online panels, and mobile polling, Black Book delivers actionable data and real-time insights for healthcare leaders nationwide. Contact Information Press Office [email protected] 8008637590 SOURCE: Black Book Research press release

Measles outbreak makes headway in U.S., Hampton Roads doctor weighs in
Measles outbreak makes headway in U.S., Hampton Roads doctor weighs in

Yahoo

time07-03-2025

  • Health
  • Yahoo

Measles outbreak makes headway in U.S., Hampton Roads doctor weighs in

VIRGINIA BEACH, Va. (WAVY) — A local physician is urging people to take the spread of measles seriously as it has surfaced and is moving through the U.S. rapidly during flu season. 'Measles is a very highly contagious viral infection,' said Dr. Hyeon Choi with Sentara Pediatric Physicians. 'It starts usually with high fever, cough, runny nose, conjunctivitis. You may get some white spots inside your mouth. And then, the sort of the classic, or hallmark, is that you get this rash that starts about day three to five. It starts from your face, head down, and then moves all the way down to cover the rest of your body.' In the United States, a lot of attention is on a major outbreak in Texas. According to the , that one has now climbed to more than 150 cases, including the death of an unvaccinated child. And now, there are new cases spouting up in New York, Pennsylvania and Florida. 'You are actually contagious from four days prior to the onset of the rash,' Choi said. 'So four days after the rash has started, most will recover within one to two weeks. However, many people can get complications from the measles infection, which is very serious — 10% will get ear infection, 5% will get pneumonia, and one out of every 1,000 will get encephalitis. Up to 20% of people with measles will end up being hospitalized due to the complications. And unfortunately, one to three out of every 1,000 will die from measles. Many in the health industry, including Choi, point to lower vaccination rates. Those not vaccinated or who have comprised immune systems and younger patient populations are cited to be most a risk. For the 2023-2024 school year in Hampton Roads, the vaccination rate was 94.2%, according to the Centers for Disease Control and Prevention. 'We want the level to be at 95%,' Choi said. 'So we are just under where we would see herd immunity. What's interesting is, the previous year, we were at 95.8%. So we have dropped a little bit now nationally. In all of us for the … previous school year, we were only at 92.7%. So that's where we have to be careful … as we become more complacent about vaccine preventable diseases.' Among medical and religious exemptions, there's another reason as to why parents may be pulling back on vaccinating their kids, Choi said. 'Unfortunately, there has been an increased sort of vaccine hesitancy recently,' she said. 'I think it's gotten worse since COVID, and there's a lot of information and misinformation in the media.' She recommends talking to someone you trust, such as a doctor or a pediatrician, and avoid getting information from social media. Most importantly, Choi strongly advises to get vaccinated. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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