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NCCI Publishes Third Report on Future of Workplace Safety Technology

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NCCI just announced the release of the third and final installment in its new Insights series, “The Future of Workplace Safety Technology Is Now,” which explores employer viewpoints on the latest trends in safety technology.

In the first installment of its series it shared insights from interviews with four workers compensation carriers in various stages of testing, introducing, and implementing safety technology. In its second installment, NCCI interviewed six technology innovators who are actively working with workers compensation stakeholders to create and provide various types of workplace safety technologies, For this third installment, NCCI interviewed three employers that have adopted innovative safety technology including wearables and video AI/Computer Vision.

Key insights from this new report include the following:

– – To effectively implement safety technology, an ongoing partnership between the employer, the technology provider, and the insurer is important.
– – Knowing how to interpret and use the data collected from the safety technology was a potential obstacle for at least one employer.
– – The cost of the product was not necessarily an obstacle to implementation.
– – Manufacturing and warehousing are currently the primary industry focus.
– – Employee buy-in and trust are critical for success and can be achieved through education and transparency.
– – The employers’ use of safety technologies also resulted in increased productivity and efficiencies.
– – Use of a single safety technology may not address all workplace hazards or unsafe practices but can be another tool in the toolbox for creating a culture of safety.
– – Safety technologies can be an effective tool for monitoring multiple locations remotely and in real time.

The employers interviewed discussed some of the obstacles to implementing safety technologies, including learning how to manage and act on the data collected and address employee privacy concerns. Interestingly, the cost of the safety technology was not necessarily the biggest obstacle noted by these employers.

An open, honest employer culture is important. According to one employer, employees “buy-in” when there is transparency, management explains the “why,” and wears the device themselves. While not every employee may want to wear the device, the employers believe it was now viewed like any other personal protective equipment such as a hard hat or safety glasses.

As it did for the first two articles, NCCI asked the three employers if safety technology is a “game-changer.” One employer believes that they are a “100% game-changer – especially for a department of one!” A second employer found the ability to monitor a worksite 24/7 to be a game-changer for their operations.

Interested readers can read the full report on the NCCI website.

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Despite California’s #37 Best State Ranking, it was #6 in Health Care

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The Best States rankings from U.S. News & World Report show how each of the 50 U.S. states ranks in 71 metrics across eight categories. The data behind the rankings aims to show how well states serve their residents in a variety of ways. In calculating the rankings, each of the eight categories was assigned weights based on the average of three years of data from recent national surveys that asked nearly 70,000 people total to prioritize each subject in their state.

In the Health Care category, California ranked #6 in the nation this year. The top ten were 1. Hawaii, 2. Massachusetts, 3. Connecticut, 4. New Jersey, 5. Rhode Island, 6. California, 7. Maryland, 8. New York, 9. Delaware and 10. Washington.

Out of the eight categories, the Health Care Category follows the following three metric areas:

Health Care Access

– – Population Without Health Insurance: The percentage of adults ages 19 to 64 who reported having no health insurance coverage. (U.S. Census Bureau American Community Survey 1-year estimates; 2022)
– – Child Dental Visits: The percentage of children and young adults enrolled in Medicaid who received past-year preventive dental services among those eligible for the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit for 90 continuous days. (Centers for Medicare & Medicaid Services; fiscal 2021)
– – Child Wellness Visits: The percentage of children and young adults enrolled in Medicaid and eligible for the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit who received screening services among those who should have received such services. (Centers for Medicare & Medicaid Services; fiscal 2021)
– – Adults Without Dental Visit: The age-adjusted percentage of adults who reported not visiting a dentist or dental clinic within the past year. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)
– – Adults Without Wellness Visit: The age-adjusted percentage of adults who reported they had not visited a doctor for a routine checkup within the past year. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)
– – Adults Deterred From Care Due to Costs: The age-adjusted percentage of adults who reported there was a time in the past 12 months when they needed to see a doctor but could not because they could not afford it. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)

Health Care Quality

– – Preventable Hospital Admissions: The number of preventable hospital admissions per 100,000 Medicare beneficiaries. (Centers for Medicare & Medicaid Services; 2022)
– – Medicare Enrollees With Top-Quality Coverage: The percentage of Medicare Advantage enrollees with a health plan rated 4 stars or better, among plans with a published star rating and number of enrollees. (Centers for Medicare & Medicaid Services; enrollment data as of February 2024, performance data reflective of March-June 2023)
– – Nursing Home Quality Rating: An average index score per state reflecting a proportional scale between nursing homes rated by U.S. News as “high-performing” and those rated as “below average.” (U.S. News Best Nursing Homes; 2023-2024)
– – Hospital Quality Rating: An average index score per state reflecting a proportional scale between hospitals rated by U.S. News as “high-performing” and those rated as “below average,” among hospitals that perform or treat specific procedures or conditions. (U.S. News Best Hospitals; 2023-2024)

Public Health

– – Infant Mortality Rate: The number of infants who died before turning 1 year old, per 1,000 live births. (Centers for Disease Control and Prevention; 2021)
– – Mortality Rate: The number of age-adjusted deaths per 100,000 population. (Centers for Disease Control and Prevention; 2022 provisional data)
– – Obesity Rate: The age-adjusted percentage of obese adults, based on self-reported height and weight. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)
– – Smoking Rate: The age-adjusted percentage of adults who are current smokers, based on self-reported tobacco usage. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)
– – Poor Mental Health: The age-adjusted percentage of adults who reported their mental health was not good for 14 days or more in the past 30 days. (Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System; 2022)
– – Suicide Rate: The age-adjusted rate of suicides per 100,000 population. (Centers for Disease Control and Prevention; 2022 provisional data)

Sadly, despite California’s high ranking in health care, it ranked #37 in terms of “Best States Overall.” This global category is based on ranking of the 8 sub-categories which includes health care. The California rankings in each of the 8 sub-categories was #34 Crime & Corrections, #34 Economy, #23 Education, #42 Fiscal Stability, #6 Health Care, #32 Infrastructure, #33 Natural Environment, and #50 Opportunity.

And out of the 30 Worst Places to Live, San Francisco was 3rd worst. The City by the Bay is one of the most expensive places to live in the U.S. The median income is higher here, but so are the costs for gasoline and utilities, which fall well above the national average. Job growth hovers just above 1%. Renters pay an average of $4,030 per month for a place to live. About 10% of the population lives below the poverty level. As for crime, the city experienced more than 50 murders and nearly 4,000 assaults in 2021.

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GPO Drug Middlemen Blamed for Chronic Drug Shortages – Evade Senate Bill

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According to a report by The American Prospect, the big three Group Purchasing Organizations (GPOs) – Premier, Vizent and HealthTrust use sole-source contracts to require hospitals to purchase virtually the same amount from suppliers every year. If a supplier cannot snag one of these contracts, they cannot sell to nearly all hospitals, and they cannot go forward as a business. This dramatically shrinks the manufacturers available for particular sterile injectable drugs, any of which can be thrown offline by the slightest imperfection.

The GPO structure therefore limits competition for these drugs, and exacerbates resiliency challenges. It also can increase prices, because the determining factor of getting a contract is often the highest fee a manufacturer can provide. These fees cut into supplier margins and induce them to take shortcuts to ramp up production, making the system even more vulnerable to supply shocks.

Hospitals have favored the scheme because they get paid too, through “share-backs” from the GPOs. This secures their participation and keeps the system stuck with supply challenges.

Ending the anti-kickback safe harbor would shift the GPO compensation model. They would be paid by hospitals as co-op purchasers, for finding the cheapest prices for medical supplies, rather than being paid by suppliers as for-profit operators, hunting the biggest fees for access. A market with suppliers competing for business rather than paying GPOs to get into hospitals would reduce what hospitals pay, studies have shown.

The Senate Finance Committee is releasing a bipartisan discussion draft this month that aims to tackle the epidemic of drug shortages, mostly in low-margin generic injectables used in hospitals. It attempts to reckon with the broken market structure that has created the most drug shortages in America on record.

The discussion draft uses Medicare and Medicaid payments to incentivize reform of contracting practices that put generic injectables and other drugs at heightened risk for shortages. In particular, Senate Finance Committee chair Ron Wyden (D-OR) has taken aim at group purchasing organizations (GPOs), three of which handle bulk purchasing for 90 percent of all hospitals. Sole-source contracts and profit-skimming by GPOs (and large wholesalers, which also have extreme concentration, with three controlling 90 percent of purchases) have been blamed for creating the conditions where low-margin drugs are no longer profitable to most manufacturers, thinning out the supply chain and opening it up to regular disruptions.

Yet the bill does not take what some have identified as the easiest path to breaking the power of GPOs: removing the safe harbor from anti-kickback laws that allows the companies to maintain their dominance by taking fees from hospital suppliers in exchange for inclusion in their guaranteed sale contracts.

Instead, it creates a new framework starting in 2027 called the Medicare Drug Shortage Prevention and Mitigation Program. Hospitals and other providers would be eligible for incentive payments under the program, but only if they commit to a variety of contracting reforms to ensure that certain generic drugs are no longer chronically in shortage. This includes injectables like saline, and chemotherapy drugs that have recently gone into short supply.

Some critics see that as a missed opportunity. “This draft is a convoluted, unworkable, nonsensical, overly complex mess,” said Phillip Zweig, co-founder and executive director of Physicians Against Drug Shortages, which has highlighted anti-competitive contracting practices and kickbacks as the source of the problem.

That there’s a draft at all reflects renewed attention to the problematic function of middlemen in the health care system, both on prices and the timely dispensation of treatment. Pharmacy benefit managers (PBMs), which play a similar role for prescription drugs purchased at pharmacies, have also come under scrutiny in Washington. Federal regulators are currently examining both GPOs and PBMs.

But solutions have been elusive, and while the committee is optimistic that they could really get something done, critics argue that there are much simpler alternatives available: in this case, making pay-to-play GPO schemes illegal again.

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Jury Awards $971K to Female L.A. County Sheriff Captain for Discrimination

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The Malibu Times as well as a story in the Conejo Valley Acorn, reports that Malibu/Lost Hills Sheriff’s Capt. Jennifer Seetoo has won her lawsuit against Los Angeles County implicating former Sheriff Alex Villanueva. Villanueva was accused of discrediting Seetoo by spreading false rumors about her and denying her the opportunity to interview for a promotion. In just under two hours of deliberations, a jury awarded Seetoo just over $971,000 in damages.

The trial unfolded over nine days of testimony from April 8 to 19 at the Stanley Mosk Courthouse in downtown L.A. Among the witnesses were Seetoo herself and former L.A. County Sheriff Alex Villanueva, under whose administration the alleged mistreatment occurred. Villanueva himself was not named as a defendant in the lawsuit.

Seetoo started with LASD as a custody assistant in 1997 at age 20. She was first in her class at the academy and rose through the ranks, arriving at Malibu/Lost Hills sheriff station as operations lieutenant, or second-in-command, in November 2018.

On her first day the captain, Josh Thai, suffered a medical emergency, making her acting captain. That same week saw the Borderline mass shooting and the Woolsey fire, with Seetoo leading the station’s response to that historic disaster.

In early December Villanueva was sworn in as sheriff, having campaigned on a promise to let local communities choose their captains.

According to Seetoo’s original complaint, filed in January 2020, she soon began to face accusations from higher-ups that she was jockeying for the absent captain’s job. These included false comments about an “inappropriate relationship” with the city manager in one of the municipalities in her jurisdiction, insinuations which Seetoo believed came from the office of the sheriff himself.

Seetoo was removed as acting captain and told she owed additional time as watch commander to be eligible for promotion. But this policy of Villanueva’s was not consistently applied to male officers, her suit alleged. She was also prevented from transferring to the detective bureau for a similar reason.

When the captain position at Lost Hills opened in June 2019, Seetoo applied but did not get an interview. The 10 candidates selected to interview were all male.

City officials told Seetoo they had sent a letter to LASD demanding that she be considered, which made her concerned about the potential repercussions. After Agoura Hills honored her Woolsey fire work by asking her to ride in the Reyes Adobe Parade, new Lost Hills Capt. Matt Vander Horck was allegedly directed to remove Seetoo from the operations lieutenant position he had asked her to fill, as well as her role as Malibu liaison.

At that point, in October, Seetoo complained about the unfounded rumors and retaliation in an email to a commander. Shortly thereafter Vander Horck told her the decision had been made to transfer her to West Hollywood. Sending employees to work at stations far from their homes as punishment is a familiar tactic in the sheriff’s department, known as “freeway therapy.” Vander Horck himself was abruptly removed as captain and transferred in Feb. 2020.

Although Villanueva was not named as a party in the lawsuit, he was accused of spreading an unfounded rumor that the married Seetoo, then the Malibu Sheriff’s liaison, was having an affair with a city manager in Agoura Hills, a city in her jurisdiction. Villanueva did testify at the trial, but so did a Villanueva colleague, an assistant sheriff who contradicted Villanueva’s testimony. That witness testified that he heard the rumor directly from Villanueva, who stated it as if it was a fact. The former Agoura Hills city official, who now works for another nearby municipality, testified in support of Seetoo, a mother of two, that the rumor was completely baseless and unsubstantiated.

Seetoo did not allege discrimination by her direct superiors, but rather from the very top of the department. Her complaint mentioned “spies” planted by the sheriff to watch her work. It also spoke of a larger pattern of discrimination against female sworn officers in the LASD under Villanueva.

In May 2022 Seetoo finally became the first female captain at Lost Hills.

Jurors found in Seetoo’s favor after deliberating for just over one and a half hours. The bulk of the jury award – $750,000 – was for non-economic losses including harm to her reputation and emotional distress. An additional $221,369 was awarded for lost earnings and benefits, bringing the total to $971,369. Seetoo also won legal fees.

Seetoo’s attorney, Kathleen Erskine, said, “It has been a highlight of my career to represent Jennifer Seetoo. She led the Malibu/Lost Hills Station with bravery and skill during the Woolsey Fire, one of the most devastating events in its history. Rather than allowing her to compete for the promotion she deserved, former Sheriff Alex Villanueva and his high-ranking executives discriminated and retaliated against her.”

The ongoing case is Jennifer Seetoo v County of Los Angeles et. al assigned to Hon. Rupert A. Byrdsong in Department 28 Stanley Mosk Courthouse.

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15 Telehealth Legislative Proposals Under Congressional Legislative Review

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On March 13, 2020, President Trump declared a national state of for COVID- 19, initiating the expansion of Medicare’s telehealth benefits under the section 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act.4

The Centers for Medicare & Medicaid Services (CMS) worked with Congress to waive Medicare’s restrictions on telehealth utilization, such as geographic restrictions and provider reimbursement. Prior to the public health emergency (PHE), an average of 13,000 fee-for- service (FFS) Medicare beneficiaries received telehealth services per week. At the end of April 2020, the number of FFS beneficiaries receiving telehealth services per week reached 1.7 million.

The flexibilities that Congress expanded in order to increase patient access to telehealth services during the COVID-19 Public Health Emergency were extended through the end of 2024 in the Consolidated Appropriations Act of 2023. Additionally, CMS has also continued certain telehealth regulatory flexibilities to align with the statutory extensions. Notable flexibilities that are set to expire at the end of 2024 include:

– – The ability for Medicare patients to receive telehealth services in their home;
– – Removal of geographic restrictions for originating site for non-behavioral/mental telehealth services;
– – Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) are permitted to serve as a distant site provider for non-behavioral/mental telehealth services;
– – The ability to deliver certain non-behavioral/mental telehealth services using audio-only communication platforms;
– – Removing the requirement for an in-person visit within six months of an initial behavioral/mental telehealth service, and annually thereafter; and
– – Allowing telehealth services to be provided by all eligible Medicare providers.

During an hours-long House Energy and Commerce subcommittee hearing this week, lawmakers considered 15 different legislative proposals surrounding telehelath access, noting changes in Medicare will impact decisions of private insurers.

“There’s an urgent need to extend these flexibilities because it’s going to run out,” said Rep. Anna Eshoo, D-Calif. “We need to take action on this.”

Lawmakers lauded the benefits of telehealth during a hearing Wednesday, but House members also raised questions about cost, quality and access that still need to be answered as a year-end deadline looms. As a December deadline draws closer, legislators are working to hash out details about extending or making pandemic-era telehealth flexibilities in Medicare permanent.

Telehealth offers promising support to providers struggling to keep pace with current workforce shortages. The Health Resources and Services Administration (HRSA) projects a shortage of 139,940 physicians by 2036. Currently, there are 39.8 primary care physicians per 100,000 people in rural areas, compared to 53.3 primary care physicians per 100,000 people in urban areas

Telehealth and remote patient monitoring can help alleviate some of these workforce challenges. According to a 2022 survey, 8 in 10 practitioners reported that retaining telehealth for health care practitioners would make them more likely to continue working in a role that maintains flexibility.

According to the testimony at Wednesday’s hearing of Eve Cunningham, M.D., group vice president and chief of virtual care and digital health at Renton, Washington-based Providence health system said: “Telehealth has become an integrated part of Providence’s care delivery system making up about 20% of ambulatory care visits. Telehealth services are deployed across 93 acute care hospitals, including 42 hospitals from other health systems, and two high schools, with more than 1.2 million telehealth visits annually,”

“Telehealth is no longer a nice to have, but a core function of our healthcare delivery,” Cunningham said. She added, “Telehealth expands access to high-quality, coordinated care to more people in more places. Telehealth enables us to offer specialty services in remote and rural areas like Kodiak, Alaska, while also allowing us to care for underserved communities in urban areas like Los Angeles,” she said.

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San Diego Pharmacy Pays $350,000 for Mishandling Controlled Substances

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Palm Care Pharmacy, a San Diego County pharmacy chain with a storefront in El Cajon, has paid $350,000 to resolve allegations that it diverted controlled substances, failed to keep necessary accounting records for controlled substances, and improperly sold pseudoephedrine chemical products.

The settlement arises from a U.S. Drug Enforcement Administration investigation into suspected illegal activity at Talimi International, Inc. d/b/a Palm Care Pharmacy. Based on an inventory audit conducted by the DEA and other investigative activities, the government concluded that Palm Care Pharmacy’s El Cajon location committed multiple violations of the Controlled Substances Act and the Combat Methamphetamine Epidemic Act from 2018 through 2022.

The government alleged that Palm Care Pharmacy failed to control its inventory of controlled substances, failed to maintain a complete record of controlled substances and the transactions, and sold listed chemical products (e.g., pseudoephedrine) without the necessary training and certification.

Palm Care Pharmacy’s failure to control inventory resulted in unaccounted-for pills, including: opioids (oxycodone, hydrocodone, and tramadol), benzodiazepines (Xanax), and muscle relaxants (Soma).

In addition to paying $350,000 to resolve the government’s claims, Palm Care Pharmacy entered into a Memorandum of Agreement with the DEA requiring Palm Care Pharmacy to undertake additional measures to handle controlled substances properly and safely.

“Accurate record keeping prevents controlled substances from ending up in the wrong hands,” said DEA Diversion Program Manager Rostant Farfan. “DEA will continue to hold registrants accountable to ensure they are operating within the closed system of distribution.”

This settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the Southern District of California and the Drug Enforcement Administration.  This case was prosecuted by Assistant U.S. Attorney Dylan M. Aste. The claims resolved by the settlement are allegations only, and there has been no determination of liability.

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New Mandatory Autobraking Standard Should Reduce Costly Comp Claims

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According to recent studies published by the National Council on Workers’ Compensation (NCCI) workers’ compensation has experienced a long-term decline in overall claim frequency, thanks to automation, robotics and continued advances in workplace safety.

However, for WC Motor Vehicle Accident (MVA) claims, the story is quite different, with frequency declining for many years and then suddenly turning upward. These accidents can be very severe and are responsible for a significant portion of fatal WC claims. MVA lost-time claims continue to cost over 80% more than the average lost-time claim, because MVA claims tend to involve severe injuries (e.g., head, neck, and spine).

In its 2020 update, NCCI noted that according to the National Highway Traffic Safety Administration (NHTSA) “the installation of automatic emergency braking (AEB) was part of a voluntary commitment by 20 automakers to equip virtually all new passenger vehicles with low-speed AEB that includes forward collision warning by September 1, 2022. The NHTSA further noted that “manufacturers have made great strides in providing advanced safety to consumers compared to 2018, when only 30% of their new vehicles were equipped with AEB.” The the Insurance Institute for Highway Safety maintains that autobraking is making driving safer, estimating that the technology could cut rear-end collisions in half.

This month the voluntary efforts of these 20 automakers have become a mandatory requirement for all of them.

The National Highway Traffic Safety Administration (NHTSA) finalized Monday a new Federal Motor Vehicle Safety Standard which makes automatic emergency braking (AEB), including pedestrian AEB, standard on all passenger cars and light trucks by September 2029. According to the agency, this safety standard is expected to significantly reduce rear-end and pedestrian crashes, saving at least 360 lives a year and preventing at least 24,000 injuries annually.

AEB systems use sensors to detect when a vehicle is close to crashing into a vehicle or pedestrian in front and automatically applies the brakes if the driver has not. The new standard requires all cars be able to stop and avoid contact with a vehicle in front of them up to 62 miles per hour and that the systems must detect pedestrians in both daylight and darkness. In addition, the standard requires that the system apply the brakes automatically up to 90 mph when a collision with a lead vehicle is imminent and up to 45 mph when a pedestrian is detected.

In June 2023, the National Safety Council (NSC) supported NHTSA’s notice of proposed rulemaking to require AEB and pedestrian AEB on new passenger cars and light trucks. The standard fulfills a provision in the Infrastructure Investment and Jobs Act to establish minimum performance standards requiring that all passenger vehicles be equipped with AEB and also aligns with the Department of Transportation’s National Roadway Safety Strategy, further embracing the Safe System Approach by directly taking a step toward making safer vehicles, a pillar of the holistic approach to roadway safety.

NSC believes the development, design, and accessibility of vehicle technology are key components to addressing the tragic trend of roadway fatalities. Improvements in vehicle safety must take into account risks to both vehicle occupants and non-occupants, and ways to mitigate these risks must be clearly communicated to the public.

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Sedgwick Announces its Next Phase of AI Technology

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Sedgwick, announced several new updates to its artificial intelligence-powered (AI) technology program, ahead of the upcoming RISKWORLD 2024, the annual conference of RIMS, Sedgwick also said it “remains at the vanguard of technological innovation in the industry with its pioneering generative AI technologies and claims management applications.”

The latest enhancements are significant milestones on Sedgwick’s journey of technology evolution and have been supported by dedicated research and development in predictive modeling, machine learning and now, generative AI. This work has been propelled by the company’s vast global dataset and expert in-house data science and technology teams.

Their goal is to expedite the claims process by predicting, addressing, and automating steps in the claim lifecycle, thereby enhancing consumer experiences, and streamlining claim resolutions. Claim resolution times are expected to decrease, early adopters will swiftly benefit from the technological advancements, and the overall experience for Sedgwick’s consumers and clients will be significantly elevated.

Sedgwick’s technology stack is built around several AI-enhanced tools that comprise a scalable, rapidly deployable platform. Recent enhancements to Sedgwick technologies include:

1- Sidekick+: In April, Sedgwick achieved integration of generative AI tools into its proprietary technology program with a best-in-class claims workflow. New updates to Sidekick+, an industry-first application that integrates Microsoft/OpenAI’s ChatGPT technology with Sedgwick’s established claims management tools, leverage API integration so that claim professionals automatically receive medical document summarizations directly into their claim files.

Sidekick+ has processed 50,000 documents in the initial pilot with greater than 98% accuracy in its summarizations. Sidekick is bundled with Sedgwick’s digital intelligence suite, including predictive models and decision engines, so that AI can prescribe optimal workflows, leading to genuine process transformation. Sedgwick was named by Foundry’s CIO as a 2024 CIO 100 Award winner for Sidekick+, which is a first-of-its-kind application developed by the company’s technology team. Foundry’s CIO 100 award recognizes enterprise excellence and innovation in IT.

2- AI care guidance: Sedgwick has expanded its offerings with the launch of an AI-powered care guidance application to identify claims on workers’ compensation programs with integrated managed care whose progression could benefit from early clinical intervention. The proprietary model uses modern AI, machine learning and natural language processing to rapidly review unstructured data – such as claim notes, correspondence, medical bills, and clinical documentation – and collect meaningful, actionable information for review. By identifying subtle patterns that might otherwise be overlooked,

AI care guidance detects the warning signs of claim severity early in the process and facilitates prompt referrals to appropriate clinical resources.

3-  mySedgwick: With an eye toward continued innovation addressing communication gaps in the claims process, mySedgwick – Sedgwick’s customer-centric self-service tool and virtual guide through the claims journey – has been refreshed with a simplified, mobile- first user experience for U.S. casualty and workforce absence clients and their employees/customers. Today, nearly 70% of claimants use mobile devices to check on their claims and ask questions – up from 30% just three years ago.

AI-backed chat capabilities can address many claims questions in real time or direct claimants to their assigned examiners for more complex queries. This update simplifies the claims experience and meets claimants where they are in the digital realm.

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Two California Hospitals Rank “A” and Three Rank “F” in Hospital Ratings

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The Leapfrog Group is a non-profit organization in the United States that focuses on patient safety, quality, and transparency in healthcare. It was founded in 2000 by large employers and healthcare experts to work to improve the healthcare system through public reporting initiatives.

For more than 20 years, The Leapfrog Group has collected, analyzed, and published hospital data on safety and quality in order to push the health care industry forward. Leapfrog’s bold transparency has promoted high-value care and informed health care decisions – and helped trigger giant leaps forward in the safety, quality, and affordability of U.S. health care.

Leapfrog just released its spring 2024 Hospital Safety Grades, assigning an “A,” “B,” “C,” “D” or “F” to nearly 3,000 general hospitals on how well they prevent medical errors, accidents and infections. Nationally, patient experience – a set of measures using patient-reported perspectives on hospital care – indicates significant signs of improvement since the fall 2023 Safety Grades, and preventable health care-associated infections show a sustained drop after unprecedented rates during the height of the pandemic.

In addition to assigning letter grades to individual hospitals, The Leapfrog Group also reports best patient safety performance by state and, for the first time, by metro area based on highest percentage of “A” hospitals. In spring 2024, Utah ranks number one among states for the second cycle in a row. The top three metro areas are Allentown (Pennsylvania), Winston-Salem (North Carolina), and New Orleans (Louisiana).

Three California hospitals made the Leapfrog list of the 10 nationwide to receive an “F” grade in The Leapfrog Group’s spring safety rankings, released May 1.

– – Mission Community Hospital (Panorama City)
– – Pacifica Hospital of the Valley (Sun Valley)
– – Providence St. Mary Medical Center (Apple Valley)

There are 15 hospitals Leapfrog has rated with 25 consecutive “A” grades. Two of them are in California.

– – French Hospital Medical Center (San Luis Obispo)
– – Kaiser Permanente Orange County-Anaheim Medical Center

Twice a year, the nonprofit healthcare watchdog organization publishes a letter grade for 3,000 hospitals on how well they prevent medical errors, accidents and infections. Among the 3,000 hospitals evaluated nationwide, fewer than 1 percent received an “F.”

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Walmart Announced Closure of 51 Clinics and Exit from Health Care Services

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May 1st, 2024, marked a turning point for Walmart’s healthcare ambitions. All 51 Walmart Health clinics in six states will be closed, and the giant retailer will end virtual health care services, the company said Tuesday.

The company had opened these clinics next to its superstores, and offered primary and urgent care, labs, X-rays, behavioral health and dental work. It had expected that it could use its massive financial scale and store base to offer convenient, low-cost services to patients in rural and underserved areas that lacked primary care options.

The decision, came as a shock to many. Just five years ago, Walmart had entered the healthcare scene with a bold promise: to disrupt the system and provide high-quality, low-cost care as an alternative to traditional doctor’s offices. Their clinics offered primary care, urgent care, x-rays, and even dental work, all conveniently located next door to the familiar blue vestibules.

“Health care looks like a big opportunity,” Walmart CEO Doug McMillion said in 2020, shortly after the first clinics opened.

However, the dream of revolutionizing healthcare proved elusive. Walmart cited “challenging reimbursement environments and escalating operating costs” as reasons for the closure. In simpler terms, the clinics just weren’t profitable enough. This echoed a wider trend – Walgreens had recently shuttered a significant number of their own in-store clinics, suggesting that the retail healthcare model might not be sustainable in the current climate.

Ateev Mehrotra, a professor of health care policy and medicine at Harvard Medical School who researches retail health clinics said Walmart’s closures reflect the challenges for primary care providers in the United States.

The closure leaves many patients scrambling for alternatives. Walmart has assured them that existing appointments will still be honored, and they’re working to connect patients with other providers within their insurance networks. However, finding a new doctor, especially in underserved areas, can be a daunting task.

The impact goes beyond patients. Hundreds of healthcare workers, from doctors and nurses to administrative staff, now face an uncertain future. Walmart has offered them the opportunity to transfer to other positions within the company, but for many, this may not be a viable option.

The story of Walmart’s healthcare experiment serves as a cautionary tale. While the goal of affordable, accessible care was noble, the execution proved difficult. The complex landscape of healthcare reimbursement and the high cost of operation ultimately proved insurmountable.

However, Walmart’s exit doesn’t necessarily negate the potential of retail healthcare entirely. It simply underscores the need for a more sustainable model. The future of affordable healthcare access remains an open question, and Walmart’s story serves as a reminder of the ongoing struggle to find a solution that works for everyone.

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