Mohan Venkataraman

As someone who has long worked in the healthcare technology ecosystem, I am thrilled to see greater momentum of payers moving from regulatory planning to operational execution - this article is a good read on that shift. Cotiviti’s “intelligent and highly scalable” payment integrity solutions play a vital role in reducing administrative costs and enabling faster patient access, directly supporting the long‑sought goals of Value‑Based Care(VBC)! #Cotiviti #PaymentIntegrity #HealthcareTechnology #FWA #ValueBasedCare #VBC

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The U.S. Department of Veterans Affairs is integrating #AI to transform its Electronic Health Record (EHR) system. By validating early AI use cases, the VA aims to enhance EHR functionalities, reduce administrative burdens and improve patient care. Learn more about this strategic approach here: https://carah.io/cdf9f

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Is Dental Industry Shrinking? Recent Halloween article on decline in cavities and costs by CNBC prompted a deep research opportunity for sikka.ai https://lnkd.in/gTssMVVq Current dynamic reflects a profound structural and economic shift where low-margin, high-volume transactions are being strategically replaced by high-value, specialized procedural volume. ​Raw utilization data derived from thousands of dental practices consistently shows positive growth. Sikka Insights industry trends data, which aggregates de-identified information on procedure volume, indicates year-over-year increases across major service categories. For example, recent analyses confirm positive percentage change trends in Orthodontics (+4%), Restorative (+3%), Diagnostic (+3%), and Prosthodontics (+2%) volume compared to the same period in the prior year.12 This sustained growth is further supported by macro-level forecasts, which project the U.S. dental services market to achieve robust annual growth rates, ranging from a Compound Annual Growth Rate (CAGR) of 4.5% to as high as 12.1% through 2032. According to DeltaDentalinstitute.com, a key finding that explains the paradox of rising revenue amid concerns of shrinking volume is the shift in restorative care patterns. Data indicates an inverse correlation between simple and complex procedures among adults aged 19–64: Direct restorations (simple fillings) volume declined, while Indirect restorations (crowns, bridges, and other complex, high-cost procedures) volume increased significantly. This trend represents quantitative evidence of accumulated deferred care. Patients postponed simple, low-cost fillings (a low-value essential procedure) until the decay progressed to a point requiring a much more expensive, high-acuity intervention, such as a full crown or even an implant. This transformation of pathology from manageable to complex results in a higher average revenue per procedure, creating an artificial inflation of "high-value" volume. ​The cost structure of elective dentistry acts as a primary gatekeeper for volume growth. As cosmetic services frequently fall outside the scope of standard dental insurance, patients are required to cover the full expense out-of-pocket. Given the documented increase in the overall cost of dental care, this out-of-pocket burden represents a significant barrier, especially for simple aesthetic procedures that may be viewed as non-essential. The volume shrinkage observed in this category is a direct function of cost sensitivity. All practice, revenue and procedure indicators are flat. “More dentists are skeptical than are confident in the overall U.S. economy,” said Marko Vujicic Ph.D., ADA chief economist and vice president of HPI. sikka.ai empirical data from thousands of practices is agreeing with this but there are certain growth areas. Please write to me for full report.

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What if your biggest payment integrity opportunity isn't recovery but prevention? Explore the shift: https://go.cgi.com/4htvDk3   For many healthcare payers, payment integrity still begins after a claim has been paid. In our latest blog, Karen Ballard, MBA, examines how connecting data, technology and business teams can help shift the focus upstream. The result is a more proactive approach that creates greater value across the organization.   Read on to discover practical strategies to embed payment integrity throughout the claims life cycle.   #CGIUS #WeAreCGI #CGIProperPay #PaymentIntegrity #HealthcareInnovation

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Digital oncology is entering a moment where EMR and telemedicine integration are becoming essential for delivering faster, safer, and more patient-centric cancer care. My recent article published in BW Wellbeing World captures this transition in detail. Integrating EMRs with telemedicine is becoming the foundation of cancer care that feels more connected, more responsive, and more humane. When EMR systems and telehealth platforms work in sync, the impact is immediate and tangible: Doctors make faster, more confident decisions because every detail, scan, report, and history is available in seconds, even during virtual consultations. Care continues between appointments, with remote monitoring capturing pain, fatigue, or changes early enough for nurses to intervene before symptoms worsen. Travel becomes lighter and less frequent, especially for those in rural or underserved areas who often face the heaviest burden in accessing care. Patients feel more in control, using simple digital tools that remind them, guide them, and support them through their treatment journey. Clinical outcomes improve, not because of bigger hospitals, but because care becomes more proactive and personal. At the same time, this reminds us that a digital-first future demands a prepared healthcare workforce and stronger long-term strategies. And above all, it calls for recognising the pivotal role oncology nurses play in making these technologies truly meaningful for patients. As cancer cases continue to rise, the future of oncology will belong to systems that understand the patient not just as a diagnosis, but as a human being navigating one of the hardest chapters of their life. This is where healthcare needs to move, and it needs to happen now. #digitaloncology #healthtech #telemedicine #emrintegration #oncologycare #patientcentriccare

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"Given the role that technology infrastructure plays in supporting clinical care delivery tools, from EHR systems to networked medical devices, wearables and sensors, cybersecurity is no longer just an IT issue. It is a critical component of clinical safety, operational continuity, financial stability and organizational trust." https://lnkd.in/ePc_d_nK

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The AHA's recent letter to the Office of Science and Technology Policy highlights the delicate balance between innovation and regulation in AI. By recommending synchronized policies and streamlined barriers, they advocate for safer, more effective AI use in healthcare. A must-read for industry insiders! https://ow.ly/yYra50XkA6v

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