{ "version": "2026-10-09c", "about": "Public data for the research explorer at kentapplied.com/research/ai-tools-by-organization/ and the 'Find the right service' quiz: six kinds of healthcare organizations, their top problems, one sourced figure for each (the source, its exact words or, for a figure we computed, how we computed it, the year and the population), and the tools that address each. Tools whose status is not 'launch' are not on the menu ('not-on-menu'): they show with no price, and you can ask about them in a written proposal. Tools that read patient data ('after-baa') start only after a signed BAA. CC BY 4.0, Kent Applied.", "segments": [ { "id": "health-systems", "name": "Large health systems and academic medical centers", "short": "Health systems", "who": "Systems with six or more hospitals, and teaching hospitals", "size": "aha_ff", "size_line": "3,567 of the 5,121 US community hospitals belong to a health system of any size.", "problems": [ "hs-costs", "hs-labor", "hs-capacity", "hs-denials", "hs-web", "hs-regulatory", "hs-chna", "hs-research" ] }, { "id": "community-hospitals", "name": "Community, rural and critical access hospitals", "short": "Community hospitals", "who": "Independent and small-system hospitals, rural hospitals and critical access hospitals", "size": "aha_ff", "size_line": "1,797 of the 5,121 US community hospitals are rural, and some of those also belong to a system.", "problems": [ "ch-margins", "ch-staffing", "ch-payer", "ch-bypass", "ch-price", "ch-funding", "ch-credentialing" ] }, { "id": "health-centers", "name": "Health centers, free clinics and health departments", "short": "Health centers", "who": "HRSA-funded health centers and look-alikes, free and charitable clinics, local health departments", "size": "kff_chc_count", "size_line": "1,356 health center organizations served more than 32.7 million patients in 2025.", "problems": [ "hc-coverage", "hc-cash", "hc-turnover", "hc-compliance", "hc-target", "hc-reporting", "hc-language" ] }, { "id": "practices", "name": "Independent and specialty practices", "short": "Practices", "who": "Physician groups, dental offices, behavioral health and therapy practices, other small clinical businesses", "size": "census_practices", "size_line": "440,667 practice firms with employees; 92.3% have fewer than 20.", "problems": [ "pr-pa", "pr-denials", "pr-payment", "pr-staffing", "pr-credentialing", "pr-found", "pr-reviews" ] }, { "id": "post-acute", "name": "Post-acute and senior care", "short": "Post-acute and senior care", "who": "Skilled nursing, home health, hospice, senior living and PACE", "size": "medpac_counts", "size_line": "In 2024, about 14,400 freestanding skilled nursing facilities and 6,706 hospices served Medicare patients, and more than 12,000 home health agencies were certified to take part in Medicare.", "problems": [ "pa-turnover", "pa-ma", "pa-survey", "pa-referrals", "pa-hospice", "pa-rates", "pa-documentation", "pa-census" ] }, { "id": "health-tech", "name": "Health-tech, service firms and associations", "short": "Health-tech and associations", "who": "Digital health companies, revenue cycle and staffing firms, associations and medical societies", "size": "hbma", "size_line": "One billing association alone, HBMA, counts nearly 300 revenue cycle firms and billing departments as members.", "problems": [ "ht-results", "ht-denials", "ht-credentialing", "ht-selling", "ht-rules", "ht-membership", "ht-ai-answers" ] } ], "areas": [ { "id": "financial", "name": "Money and payers" }, { "id": "administrative", "name": "Paperwork and back office" }, { "id": "workforce", "name": "Staffing" }, { "id": "compliance", "name": "Rules, surveys and audits" }, { "id": "growth", "name": "Patients, referrals and customers" }, { "id": "operational", "name": "Daily operations" } ], "problems": [ { "id": "hs-costs", "segment": "health-systems", "title": "Rising costs for supplies and drugs", "area": "financial", "who": "CEO, CFO, COO, supply chain", "stat": "aha_coc_supplies", "products": [ "contract-register" ], "existing_offers": [], "help": "The Payer and Vendor Contract Register reads your hospitals' vendor contracts and warns each contract's owner 90 days before the deadline to cancel, so nothing renews at a higher price by surprise. It also checks a monthly sample of invoices against the agreed prices.", "note": "You can start with your top 50 vendor contracts for $6,500, credited toward the register if you buy it within 90 days.", "order": [ "contract-register" ] }, { "id": "hs-labor", "segment": "health-systems", "title": "The cost of agency staff, overtime and rising wages", "area": "workforce", "who": "COO, CNO, CFO", "stat": "aha_coc_workforce", "products": [ "contract-register", "labor-retention-desk" ], "existing_offers": [ "capacity-forecast" ], "note": "You can start with three months of staffing agency invoices checked against approved timecards, for $7,500, credited toward the register within 90 days. The forecast begins with a $14,500 test on two years of your own history, and the daily forecast is built only if it beats the way you plan staffing today.", "help": "The Payer and Vendor Contract Register checks staffing agency invoices against approved timecards, and a monthly sample against your contracted prices. The Capacity and Staffing Forecast predicts how many patients each unit will have, so busy days are staffed in advance rather than covered with last-minute overtime.", "order": [ "contract-register", "capacity-forecast", "labor-retention-desk" ] }, { "id": "hs-capacity", "segment": "health-systems", "title": "Discharge delays that keep beds full", "area": "operational", "who": "COO, CNO, case management", "stat": "aha_discharge", "products": [ "discharge-placement-desk" ], "existing_offers": [ "throughput-diagnostic" ], "note": "If the hold-up is finding a nursing home or rehab bed, the plan says so and focuses on what your team controls, such as how early that search starts. The timestamps have names and record numbers removed but are still patient-level data, so the work starts once a data use agreement or a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "note_sources": [ "hipaa_baa" ], "help": "The Throughput Diagnostic finds the one step that holds up your discharges, using timestamps your electronic health record already keeps. In three weeks you learn what each day of delay costs and get a plan for the first change to make.", "order": [ "throughput-diagnostic", "discharge-placement-desk" ] }, { "id": "hs-denials", "segment": "health-systems", "title": "Denied claims and payer contract terms", "area": "financial", "who": "CFO, revenue cycle, managed care", "stat": "premier", "products": [ "contract-register", "denial-desk" ], "existing_offers": [], "note": "The register reads contracts, not claims, so it needs no patient data. You can start with your top 10 payer contracts for $9,500, credited toward the register within 90 days. Working the denied claims themselves means reading patient information, so the Denial and Appeals Desk starts only after a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "note_sources": [ "hipaa_baa" ], "help": "A missed appeal deadline turns a claim the payer would have paid into a write-off. The Payer and Vendor Contract Register puts every payer's deadlines to bill and to appeal in one searchable list, with the contract page cited.", "order": [ "contract-register", "denial-desk" ] }, { "id": "hs-web", "segment": "health-systems", "title": "Website accessibility and price transparency rules", "area": "compliance", "who": "Web team, compliance, revenue integrity", "stat": "ecfr_504", "products": [ "price-transparency-monitor" ], "existing_offers": [], "help": "The Price Transparency and Accessibility Monitor tests your hospitals' websites each week against the May 2027 federal accessibility rule and drafts a fix for each failure it finds. It also checks a sample of your posted prices against your chargemaster (your master price list).", "note": "A health system can start with a one-time audit of every website it runs for $7,500, credited toward the monitor within 90 days.", "order": [ "price-transparency-monitor" ] }, { "id": "hs-regulatory", "segment": "health-systems", "title": "Keeping up with regulations, policies and accreditation", "area": "compliance", "who": "Compliance, accreditation, policy owners", "stat": "aha_reg", "products": [ "custom-ai-tool", "hospital-survey-readiness" ], "existing_offers": [ "ai-governance" ], "note": "The $7.6 million comes from a 2017 study, so treat it as dated. If you already license an AI assistant that can search your documents, try it on your policy manual before paying for a custom tool.", "note_sources": [ "jc_chai_ai" ], "help": "In September 2025 the Joint Commission and the Coalition for Health AI published guidance on responsible AI use, and its recommendations begin with AI policies. The AI Governance Starter finds every AI tool in use and writes your AI policy. A Custom AI Tool can answer staff questions from your policy manual, citing the page.", "order": [ "ai-governance", "custom-ai-tool", "hospital-survey-readiness" ] }, { "id": "hs-chna", "segment": "health-systems", "title": "Community health needs assessments due every three years", "area": "compliance", "who": "Community benefit, population health", "stat": "tax4959", "products": [ "funding-desk" ], "existing_offers": [], "help": "The Funding and Needs Assessment Desk drafts every required section of your community health needs assessment, links each figure to its source and sorts the community comments your team gathers into themes, so your board gets a complete draft to review and adopt.", "note": "The needs assessment is priced on its own, with no monthly fee: $14,500, or $10,500 if the desk's weekly funding watch is already in place.", "order": [ "funding-desk" ] }, { "id": "hs-research", "segment": "health-systems", "title": "Clinical trials that take months to open (academic centers)", "area": "operational", "who": "Clinical research office", "stat": "ku_trials", "products": [ "custom-ai-tool" ], "existing_offers": [], "note": "We would test the tool on past studies, comparing its drafts with the ones your staff wrote, before anyone relies on it. It works on the documents your own office prepares, so it won't shorten time spent waiting on sponsors or review boards.", "sizes": [ "academic-medical-center" ], "help": "A Custom AI Tool would draft each new study's coverage analysis (which costs insurance pays and which the sponsor pays) and its site budget from the study protocol, so your research staff check and approve a draft instead of starting from a blank page.", "order": [ "custom-ai-tool" ] }, { "id": "ch-margins", "segment": "community-hospitals", "title": "Thin margins, or running at a loss", "area": "financial", "who": "CEO, CFO, board", "stat": "chartis", "products": [ "contract-register", "leadership-brief" ], "existing_offers": [], "help": "The Payer and Vendor Contract Register warns you 90 days before each vendor contract renews, so none rolls over at a higher price unnoticed. It also spot-checks invoices against contract prices. The Weekly Leadership Brief shows each week which numbers slipped against budget.", "note": "To start smaller, the Contract Register can begin with your top 50 vendor contracts for $6,500, and that fee counts toward the full register if you buy it within 90 days. A hospital's version of the brief costs from $9,500 to build, then $350 a month.", "order": [ "contract-register", "leadership-brief" ] }, { "id": "ch-staffing", "segment": "community-hospitals", "title": "Agency nurses and overtime", "area": "workforce", "who": "CNO, nurse managers, CFO", "stat": "nsi_travel", "products": [ "contract-register", "labor-retention-desk" ], "existing_offers": [ "capacity-forecast" ], "note": "A good first step is three months of agency invoices checked against approved timecards, for $7,500, which counts toward the Contract Register if you buy it within 90 days. The forecast needs two years of hourly patient counts by unit, and it is tested on that history before anyone relies on it. The $66,081 comes from a recruitment firm's report, so treat it with some caution.", "help": "The Payer and Vendor Contract Register checks agency invoices against approved timecards, and a monthly sample against your contracted prices, so you catch overbilling. The Capacity and Staffing Forecast predicts each unit's patient count, so you can schedule ahead and lean less on overtime and agency nurses.", "order": [ "contract-register", "capacity-forecast", "labor-retention-desk" ] }, { "id": "ch-payer", "segment": "community-hospitals", "title": "Medicare Advantage plans that pay less or deny claims", "area": "financial", "who": "CFO, business office", "stat": "aha_ma_rural", "products": [ "contract-register", "custom-ai-tool", "denial-desk" ], "existing_offers": [], "note": "You can start the Contract Register with your top 10 payer contracts for $9,500, and that fee counts toward the full register if you buy it within 90 days. The Denial and Appeals Desk would read claims, which contain patient information, so it starts only once a business associate agreement (BAA, the contract HIPAA requires before an outside firm handles patient records) and our insurance are in place.", "note_sources": [ "hipaa_baa" ], "help": "The Payer and Vendor Contract Register lists each plan's deadlines to bill and appeal, and warns you 90 days before renewal. A Custom AI Tool can compare each plan's payments with your fee schedule, code by code, to show where each pays least.", "order": [ "contract-register", "custom-ai-tool", "denial-desk" ] }, { "id": "ch-bypass", "segment": "community-hospitals", "title": "Residents leaving town for care", "area": "growth", "who": "CEO, marketing, clinic managers", "stat": "cms_bypass", "products": [ "market-share-watcher" ], "existing_offers": [ "data-visualization" ], "note": "Both would be built on CMS's public Hospital Service Area file, which counts each hospital's Medicare inpatient stays by the patient's ZIP code. The file shows where patients went but not why, so use the map to pick which towns to look into first.", "note_sources": [ "cms_hsa" ], "help": "A Data Visualization and Dashboards project can map where your area's Medicare patients go for hospital stays, ZIP code by ZIP code, so you see which towns mostly use other hospitals. The Market Share and Outmigration Watcher, not yet offered, would update it each year when CMS posts its new file.", "order": [ "data-visualization", "market-share-watcher" ] }, { "id": "ch-price", "segment": "community-hospitals", "title": "Price transparency fines and a 2027 website accessibility deadline", "area": "compliance", "who": "Compliance, chargemaster owner, CFO", "stat": "cfr_180_90", "products": [ "price-transparency-monitor" ], "existing_offers": [], "note_sources": [ "cms_hpt_validator", "ecfr_504" ], "help": "Every week the Price Transparency and Accessibility Monitor checks a sample of your posted prices against your chargemaster and tests your website against HHS's rule on access for people with disabilities, due May 11, 2027. It drafts each fix for its owner.", "note": "CMS's free checker looks only at the file's format, so the monitor also compares the prices themselves. If you're not ready for weekly checks, a one-time audit of your price file and top web pages costs $3,500 and counts toward the monitor if you buy it within 90 days.", "order": [ "price-transparency-monitor" ] }, { "id": "ch-funding", "segment": "community-hospitals", "title": "Grants, rural health funds and the community health needs assessment", "area": "financial", "who": "CEO, foundation or community relations", "stat": "kff_rht", "products": [ "funding-desk" ], "existing_offers": [], "note_sources": [ "irs_chna_3yr" ], "help": "Each week the Funding and Needs Assessment Desk lists the grant and state rural health fund rounds you qualify for, so a hospital without a grant writer hears in time. It drafts application text and your community health needs assessment from your own figures.", "note": "The needs assessment, which nonprofit hospitals owe every three years, is priced on its own: $10,500 with the desk in place, $14,500 without it. For one funding round, help with that application costs $5,500. Each state runs its own rounds for its share of the $10 billion, with its own rules.", "order": [ "funding-desk" ] }, { "id": "ch-credentialing", "segment": "community-hospitals", "title": "Credentialing visiting and telehealth physicians", "area": "compliance", "who": "Medical staff office, CEO", "stat": "ecfr_485_616", "products": [ "custom-ai-tool" ], "existing_offers": [], "note": "Start with a one-time audit of your credentialing files: $1,500 for up to 8 clinicians or $3,500 for up to 25, credited toward the tracker within 90 days. It runs in your own Microsoft 365, Google Workspace or cloud account, so the files stay with you.", "help": "A credentialing tracker, built as a Custom AI Tool, checks each visiting and telehealth physician's file for missing documents and expiration dates, including every state license they hold, so your medical staff office sees each gap before anything lapses.", "order": [ "custom-ai-tool" ] }, { "id": "hc-coverage", "segment": "health-centers", "title": "Patients losing Medicaid at renewal or under work requirements", "area": "financial", "who": "CEO, CFO, eligibility staff", "stat": "nachc_unwind", "products": [ "medicaid-renewal-kit", "custom-ai-tool" ], "existing_offers": [], "note": "States must generally start work requirements for adults covered by the Medicaid expansion by January 1, 2027. The kit uses no patient records: your staff pull the list of patients due to renew from your own EHR.", "note_sources": [ "cms_ce_2027" ], "help": "The Medicaid Renewal Readiness Kit would give staff outreach messages in patients' languages and a checklist of who your state exempts from work requirements, to help patients keep coverage. A Custom AI Tool could answer staff questions on the new rules, citing the page.", "order": [ "medicaid-renewal-kit", "custom-ai-tool" ] }, { "id": "hc-cash", "segment": "health-centers", "title": "Thin margins and short cash", "area": "financial", "who": "CEO, CFO, board", "stat": "nachc_cash", "products": [ "funding-desk", "leadership-brief" ], "existing_offers": [], "help": "Each week the Funding and Needs Assessment Desk lists grants your center qualifies for and drafts application text from your own figures. The Weekly Leadership Brief tells leaders each week which finance numbers fell behind budget and why, so they can act right away.", "note": "To start smaller, the desk can help with one funding round for $5,500, credited toward the desk if you buy it within 90 days. A health center's version of the brief costs from $9,500 to build, then $350 a month.", "order": [ "funding-desk", "leadership-brief" ] }, { "id": "hc-turnover", "segment": "health-centers", "title": "Medical assistant and front-desk turnover", "area": "workforce", "who": "Clinic managers, HR", "stat": "nachc_ma", "products": [ "labor-retention-desk" ], "existing_offers": [], "help": "The Contract Labor and Retention Desk would show, from your HR records, which sites lose new medical assistants and front-desk staff in their first 90 days, so managers know where to act first.", "order": [ "labor-retention-desk" ] }, { "id": "hc-compliance", "segment": "health-centers", "title": "Compliance findings that put the grant at risk", "area": "compliance", "who": "CEO, compliance, HR, board", "stat": "hrsa_osv_top5", "products": [ "health-center-site-visit" ], "existing_offers": [], "help": "Health Center Site Visit Readiness checks your credentialing and privileging records every month, for employed, contracted and referral clinicians. It also matches every other HRSA requirement to your documents, so your compliance lead sees each gap before a site visit.", "note": "With a visit coming soon, you can start with a one-time scan of every requirement against your current documents for $6,500, credited toward the checker within 90 days. If your primary care association runs mock site visits, use those first; the checker keeps your evidence current between visits.", "order": [ "health-center-site-visit" ] }, { "id": "hc-target", "segment": "health-centers", "title": "Falling short of the patient target in the HRSA grant", "area": "growth", "who": "CEO, operations", "stat": "hrsa_target", "products": [ "leadership-brief", "website-reviews-social-desk" ], "existing_offers": [], "help": "The Weekly Leadership Brief tells your board whether the center is on pace for its HRSA patient target while there's time to act. The Website, Reviews and Social Desk checks every site's hours and Google listing each week, so new patients can find you.", "note": "For a health center, the brief costs from $9,500 to build, then $350 a month. The desk for 2 to 15 sites costs $9,500, then $350 a month, or you can start with a one-time check of your website and every location's listings for $3,500.", "order": [ "leadership-brief", "website-reviews-social-desk" ] }, { "id": "hc-reporting", "segment": "health-centers", "title": "Staff hours on the UDS report and the needs assessment", "area": "administrative", "who": "Quality or data lead, grants manager", "stat": "fr_uds", "products": [ "funding-desk" ], "existing_offers": [ "analytics-build" ], "note_sources": [ "uds_due", "hipaa_baa" ], "help": "The Funding and Needs Assessment Desk drafts your HRSA needs assessment, with every figure linked to its source, and reads no patient data. Later, Data Warehouse and Reporting can fill your UDS tables from the EHR all year, so at the February 15 deadline your staff only check them.", "note": "UDS reporting reads patient records, so it starts once a business associate agreement (BAA, the contract HIPAA requires before an outside firm handles patient records) and our insurance are in place. The needs assessment alone costs $14,500, with no monthly fee.", "order": [ "funding-desk", "analytics-build" ], "phi": "part" }, { "id": "hc-language", "segment": "health-centers", "title": "Serving patients in languages other than English", "area": "operational", "who": "Patient services, compliance", "stat": "kff_chc_lang", "products": [ "custom-ai-tool" ], "existing_offers": [], "note": "Federal rules require a qualified human translator to review machine translation of anything that affects a patient's rights or access to care. The tool would work on written materials that name no patient; interpreters still handle visits and phone calls.", "note_sources": [ "ecfr_92_201" ], "help": "A Custom AI Tool could draft translations of your forms, notices and flyers for a qualified translator to check and approve, so more of what patients read is in their own language.", "order": [ "custom-ai-tool" ] }, { "id": "pr-pa", "segment": "practices", "title": "Prior authorization and the back-office inbox", "area": "administrative", "who": "Front desk, billing, clinicians", "stat": "ama_pa", "products": [ "practice-back-office-inbox" ], "existing_offers": [ "vendor-evaluation" ], "note": "If a simple alert service for payer policy changes covers what you need, try one before paying for a larger tool. From January 1, 2027, Medicare Advantage, Medicaid, CHIP and federal marketplace plans must let software look up the services they cover and the paperwork each prior authorization needs. Ask any prior authorization tool you consider whether it will use those lookups.", "note_sources": [ "cms_0057f" ], "help": "If you're weighing AI tools for prior authorization, the AI Vendor Evaluation tests each one on the same cases from your practice, with patient details removed, adds up its three-year cost and tells you which to buy, if any.", "order": [ "vendor-evaluation", "practice-back-office-inbox" ], "phi": "full" }, { "id": "pr-denials", "segment": "practices", "title": "Rising claim denials", "area": "financial", "who": "Billing manager, owner", "stat": "mgma_denials", "products": [ "leadership-brief", "denial-desk" ], "existing_offers": [], "note": "Working the denied claims themselves means reading patient information, so the Denial and Appeals Desk starts only after a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "note_sources": [ "hipaa_baa" ], "help": "Denials show up as a falling collection rate and more claims unpaid after 90 days. The Weekly Leadership Brief shows the owner both numbers every week, with the reason your billing team wrote down, so a rise doesn't go unnoticed for weeks.", "order": [ "leadership-brief", "denial-desk" ], "phi": "full" }, { "id": "pr-payment", "segment": "practices", "title": "Insurance payments that don't keep up with costs", "area": "financial", "who": "Owner, administrator", "stat": "ama_medicare33", "products": [ "custom-ai-tool", "leadership-brief" ], "existing_offers": [], "note": "Medicare sets its own rates, so the comparison helps most with the plans whose contracts you negotiate. You can skip the $450 monthly fee and have your team run the tool once it's built.", "help": "A Custom AI Tool can compare your fee schedule with what each payer paid, code by code, so you see where each payer pays least before its contract renews. The Weekly Leadership Brief shows what you collected each week, against budget and by payer.", "order": [ "custom-ai-tool", "leadership-brief" ] }, { "id": "pr-staffing", "segment": "practices", "title": "Hiring medical assistants and hygienists", "area": "workforce", "who": "Office manager, owner", "stat": "mgma_ma_hiring", "products": [], "existing_offers": [], "note": "New York City bars employers from using automated tools to screen applicants unless the tool has had a bias audit in the past year, and California's rules on such tools took effect October 1, 2025. Job boards and hiring software already post jobs and schedule interviews, so a new tool from us would add little.", "note_sources": [ "nyc_aedt", "ca_ads" ], "help": "Nothing on the menu helps a practice hire, and we don't build tools that screen job applicants.", "order": [] }, { "id": "pr-credentialing", "segment": "practices", "title": "Credentialing paperwork and insurance directory listings", "area": "administrative", "who": "Office manager, each clinician", "stat": "senate_ghost", "products": [ "custom-ai-tool" ], "existing_offers": [], "note": "Each plan keeps its own directory, so your part is keeping what you report to plans current, starting with each clinician's free CAQH profile, the shared credentialing record many payers use. CAQH asks for re-attestation every 120 days. The audit costs $1,500 for up to 8 clinicians or $3,500 for up to 25, credited toward the tracker within 90 days.", "note_sources": [ "caqh_120" ], "help": "A one-time credentialing file audit (listed under Custom AI Tool) checks each clinician's file for missing documents and expiration dates, including every state license. A tracker can then keep checking those dates, so nothing lapses unnoticed. Your staff still submit applications and call payers.", "order": [ "custom-ai-tool" ] }, { "id": "pr-found", "segment": "practices", "title": "Getting found and keeping the schedule full", "area": "growth", "who": "Owner, front desk", "stat": "ada_busy", "products": [ "website-reviews-social-desk", "leadership-brief" ], "existing_offers": [], "help": "The Website, Reviews and Social Desk checks weekly that patients see the same hours, insurance and clinicians on your site and on Google, and drafts review replies and posts. The Weekly Leadership Brief shows next week's open slots and which referral sources slowed.", "note": "If all you need is accurate listings, a listings tool, which keeps your details current on Google and other directories, may be enough. The desk adds review replies that never confirm the reviewer was a patient, plus drafted posts and fixes for your website.", "order": [ "website-reviews-social-desk", "leadership-brief" ] }, { "id": "pr-reviews", "segment": "practices", "title": "Answering online reviews without revealing patient information", "area": "compliance", "who": "Owner, office manager", "stat": "ocr_reviews", "products": [ "website-reviews-social-desk" ], "existing_offers": [], "help": "The Website, Reviews and Social Desk drafts a reply to each new review that thanks the reviewer and invites them to call, without confirming they were a patient. Nothing posts until you approve it. A one-time $1,500 check can review your past replies first.", "order": [ "website-reviews-social-desk" ] }, { "id": "pa-turnover", "segment": "post-acute", "title": "Staff turnover and agency staffing costs", "area": "workforce", "who": "Administrator, DON, HR, schedulers", "stat": "medpac_snf_turnover", "products": [ "contract-register", "labor-retention-desk" ], "existing_offers": [], "note": "You can start with three months of agency invoices checked against approved timecards, for $7,500, credited toward the register if you buy it within 90 days. Nothing on the menu today lowers turnover itself.", "note_sources": [ "bowblis_agency" ], "help": "By 2022, almost half of nursing homes used agency nursing staff, up from 23% in 2018, a study in Health Affairs found. The Payer and Vendor Contract Register checks agency invoices against approved timecards, and a monthly sample against your contracted prices, so you catch overbilling. It also warns you 90 days before each agency contract's notice date, in time to renegotiate.", "order": [ "contract-register", "labor-retention-desk" ] }, { "id": "pa-ma", "segment": "post-acute", "title": "Medicare Advantage contracts and denials", "area": "financial", "who": "CFO, business office, UR coordinator", "stat": "senate_psi", "products": [ "contract-register", "denial-desk" ], "existing_offers": [], "note": "You can start with your top 10 payer contracts for $9,500, credited toward the register within 90 days. Working the denied claims themselves means reading patient information, so the Denial and Appeals Desk starts only after a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "note_sources": [ "hipaa_baa" ], "help": "A missed appeal deadline turns a payable claim into a write-off. The Payer and Vendor Contract Register lists each Medicare Advantage contract's prior authorization and appeal terms, with the page cited, and warns you 90 days before each renewal so you can renegotiate.", "order": [ "contract-register", "denial-desk" ] }, { "id": "pa-survey", "segment": "post-acute", "title": "Inspections, fines and star ratings (nursing homes)", "area": "compliance", "who": "Administrator, DON, regional clinical lead", "stat": "cms_nh_fines", "products": [ "nursing-home-survey-readiness" ], "existing_offers": [], "help": "Using CMS's public inspection files, Nursing Home Survey Readiness compares your building's citations, fines and staffing with other homes in your state and ranks the federal requirements you're most likely to be cited on. Your director of nursing gets an audit checklist for each.", "note": "Not ready to buy? Ask for a free one-page snapshot of your building's citation and fine history against your state, built from the same public files.", "order": [ "nursing-home-survey-readiness" ] }, { "id": "pa-referrals", "segment": "post-acute", "title": "Referrals that never become admissions", "area": "growth", "who": "Intake, admissions, liaisons", "stat": "cmwf_referrals", "products": [ "leadership-brief", "referral-intake-desk" ], "existing_offers": [], "note": "For a home health agency or another post-acute or senior care operator, the brief costs from $9,500 to build, then $350 a month. It uses only weekly counts by source, because HIPAA treats even a patient's admission date as identifying information.", "note_sources": [ "hipaa_dates" ], "help": "Each week the Weekly Leadership Brief shows how many referrals came from each hospital or other source and how many became admissions, so leaders see which sources are slipping. When a number drops, it quotes the reason your intake team wrote down.", "order": [ "leadership-brief", "referral-intake-desk" ] }, { "id": "pa-hospice", "segment": "post-acute", "title": "Going over Medicare's hospice payment cap", "area": "compliance", "who": "Hospice CEO, CFO, compliance", "stat": "medpac_hospice_cap", "products": [ "hospice-cap-monitor" ], "existing_offers": [], "note": "Tracking the cap needs each patient's days of care, so the monitor starts only after a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place. If your billing system already projects the cap, you may not need it.", "note_sources": [ "hipaa_baa" ], "help": "Medicare caps a hospice's average yearly payment per patient, and a hospice over the cap repays the difference. The Hospice Cap Monitor would project your payments against the cap each month, so your CFO sees an overage coming while there's time to act.", "order": [ "hospice-cap-monitor" ] }, { "id": "pa-rates", "segment": "post-acute", "title": "Medicare rate cuts and pay tied to quality scores (home health)", "area": "financial", "who": "CEO, CFO, board", "stat": "fr_hh2026", "products": [ "leadership-brief" ], "existing_offers": [], "note": "Medicare moves each home health agency's pay by up to 5% either way, based on its quality scores from two years earlier (2023's scores set 2025's pay). A home health agency's brief costs from $9,500 to build, then $350 a month.", "note_sources": [ "cms_hhvbp" ], "help": "Medicare sets the rate cut, but your quality scores also move your pay. Each week the Weekly Leadership Brief shows those scores from your own quality reports, against your targets, so leaders catch a slipping score while there's still time to fix it.", "order": [ "leadership-brief" ] }, { "id": "pa-documentation", "segment": "post-acute", "title": "Medicare claims that fail documentation review", "area": "administrative", "who": "MDS coordinator, coders, CFO", "stat": "cms_cert_snf", "products": [ "custom-ai-tool" ], "existing_offers": [ "vendor-evaluation" ], "note": "Before buying anything new, ask your EHR or coding vendor whether it already sells a pre-bill documentation check; the evaluation helps when you're comparing several. A Custom AI Tool that checks your own charts would read patient records, so it starts only after a BAA (the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "note_sources": [ "hipaa_baa" ], "help": "If you're weighing software that checks each claim's documentation before you bill Medicare, the AI Vendor Evaluation tests each one on the same cases from your organization, with patient details removed, and tells you which to buy, if any.", "order": [ "vendor-evaluation", "custom-ai-tool" ], "phi": "part" }, { "id": "pa-census", "segment": "post-acute", "title": "Filling units and beds", "area": "growth", "who": "Executive director, sales, marketing", "stat": "carescout_al", "products": [ "website-reviews-social-desk", "custom-ai-tool" ], "existing_offers": [], "note": "A Custom AI Tool could draft a same-day reply to each move-in inquiry, from wording you've approved, for your team to check and send. An inquiry may mention a parent's health, so your compliance officer decides first whether that build needs a BAA (the contract HIPAA requires before an outside firm handles patient records).", "note_sources": [ "hipaa_baa" ], "help": "At the median assisted living price, each move-in is worth about $74,400 a year. The Website, Reviews and Social Desk checks weekly that your website and Google listing show families the same hours, phone and services, and drafts each review reply for approval.", "order": [ "website-reviews-social-desk", "custom-ai-tool" ] }, { "id": "ht-results", "segment": "health-tech", "title": "Proving results to health plans and employers", "area": "financial", "who": "CEO, customer success, finance", "stat": "phti", "products": [ "client-results-report" ], "existing_offers": [ "outcomes-study" ], "note": "The study needs claims or visit records for the people in your program and for a comparison group. Until a BAA or data use agreement (the contracts HIPAA requires before an outside firm handles patient records) and our insurance are in place, it works from de-identified records or summaries.", "note_sources": [ "hipaa_baa" ], "help": "The Outcomes and ROI Study compares the people in your program with similar people who weren't in it, puts the difference in visits, admissions and costs in dollars, and writes out the method so a health plan or employer can check it.", "order": [ "outcomes-study", "client-results-report" ], "phi": "part" }, { "id": "ht-denials", "segment": "health-tech", "title": "Denied claims and payer deadlines across many clients (revenue cycle firms)", "area": "financial", "who": "Revenue cycle operations, compliance", "stat": "premier", "products": [ "contract-register", "denial-desk" ], "existing_offers": [], "note_sources": [ "ecfr_424_44", "hipaa_baa" ], "sizes": [ "revenue-cycle-firm" ], "help": "A missed deadline to bill or appeal can lose you a claim the payer would have paid. Medicare, for one, requires most claims within a year of the date of service. The Payer and Vendor Contract Register puts every payer's deadlines, for every client, in one searchable list, with the contract page cited.", "note": "The register reads contracts, not claims, so it needs no patient data. You can start with the top 10 payer contracts across your clients for $9,500, credited toward the register within 90 days. Working the denied claims themselves means reading patient information, so the Denial and Appeals Desk starts only after a BAA (business associate agreement, the contract HIPAA requires before an outside firm handles patient records) is signed and our insurance is in place.", "order": [ "contract-register", "denial-desk" ] }, { "id": "ht-credentialing", "segment": "health-tech", "title": "Hours spent checking credentials by hand (staffing firms)", "area": "administrative", "who": "Credentialing coordinators, recruiters", "stat": "bullhorn", "products": [ "custom-ai-tool" ], "existing_offers": [], "note": "To try it first, an audit of up to 25 clinician files costs $3,500, one time, credited toward the tracker if you buy it within 90 days. The tracker runs in your own Microsoft 365, Google Workspace or cloud account, so the files stay with you. The 77% comes from a survey by a company that sells staffing software, so treat it with some caution.", "sizes": [ "staffing-firm" ], "help": "A credentialing tracker, built as a Custom AI Tool, checks each clinician's file for missing documents and expiration dates, including every state license they hold. Your coordinator confirms each gap it finds, instead of recruiters checking every file by hand.", "order": [ "custom-ai-tool" ] }, { "id": "ht-selling", "segment": "health-tech", "title": "Selling to health systems that favor vendors they already use", "area": "growth", "who": "CEO, sales, security lead", "stat": "hfma_vendor", "products": [ "custom-ai-tool" ], "existing_offers": [ "ai-governance" ], "note": "Having these documents ready before a health system's security review asks for them can save you a round of back-and-forth. The Starter doesn't replace a security certification such as SOC 2. The weekly note reads only public sources, so it can run on our servers.", "help": "The AI Governance Starter writes your AI policy and lists every AI tool your company uses, ready for a health system's security review. A Custom AI Tool can send your sales team a weekly note when a target system changes leaders, budgets or vendors.", "order": [ "ai-governance", "custom-ai-tool" ] }, { "id": "ht-rules", "segment": "health-tech", "title": "Long proposed federal rules to read and comment on (societies)", "area": "compliance", "who": "Government affairs, policy staff", "stat": "fr_pfs", "products": [ "custom-ai-tool" ], "existing_offers": [ "training" ], "note": "The training works with whichever AI tools your organization has or is choosing. Proposed rules are public, so a tool that reads them can run on our servers, and a named person on your staff approves every finding and draft before it's used.", "sizes": [ "association-or-society" ], "help": "In AI Staff Training, policy staff practice on a real proposed rule, using AI to find the sections that affect members and checking each against the text. A Custom AI Tool can be built to read each new rule and draft a comment letter.", "order": [ "training", "custom-ai-tool" ] }, { "id": "ht-membership", "segment": "health-tech", "title": "Members who don't renew (associations)", "area": "growth", "who": "Membership director, executive director", "stat": "mgi_renewal", "products": [], "existing_offers": [ "predictive-model" ], "sizes": [ "association-or-society" ], "help": "Predictive Models builds a score for each member's chance of not renewing, from your own records, tested on past renewals before anyone relies on it. Your membership team gets a ranked list, so calls go first to members most likely to lapse.", "note": "It needs one to two years of member records, including who renewed and who didn't. The first week confirms those records can support a model before the rest of the work goes ahead; if they can't, nothing beyond the signing payment is due.", "order": [ "predictive-model" ] }, { "id": "ht-ai-answers", "segment": "health-tech", "title": "Losing website visitors to Google's AI summaries", "area": "growth", "who": "Communications, growth lead", "stat": "pew_ai_summary", "products": [ "website-reviews-social-desk" ], "existing_offers": [], "note": "The desk doesn't show how you appear in AI answers. To try the desk first, a one-time check of your website and listings costs $1,500, credited toward the desk within 90 days.", "help": "Fewer people click through from Google, so each visitor who arrives counts for more. Each week the Website, Reviews and Social Desk finds pages that should link to each other, such as a most-read article that never links to your membership or sign-up page.", "order": [ "website-reviews-social-desk" ] } ], "products": [ { "slug": "leadership-brief", "name": "Weekly Leadership Brief", "url": "/leadership-brief/", "group": "AI tools", "status": "launch", "menu_line": "One page a week on which numbers changed and what needs a decision.", "price": "from $6,500 + $250 a month", "duration": "1–2 weeks", "entry": { "name": "Owner's brief", "price": "$6,500", "duration": "1 to 2 weeks" }, "tiers": [ { "name": "Owner's brief", "price": "$6,500", "year_one": "$9,500" }, { "name": "Operator brief", "price": "from $9,500", "year_one": "$13,700–23,700" }, { "name": "Health system", "price": "from $22,000", "year_one": "$31,000–56,400" }, { "name": "Health system pilot", "price": "$12,500", "year_one": "$12,500" } ], "run": "$250 a month for an owner's brief; $350 for an operator; $750 to $1,200 for a health system", "runs_in": "client", "segments": [ "health-systems", "community-hospitals", "health-centers", "practices", "post-acute", "health-tech" ], "patient_data": "none", "problem_stat_by_segment": { "health-systems": "aha_expenses", "community-hospitals": "chartis", "health-centers": "hrsa_target", "practices": "ama_medicare33", "post-acute": "fr_hh2026" }, "problems": [ "ch-margins", "hc-cash", "hc-target", "pr-denials", "pr-payment", "pr-found", "pa-referrals", "pa-rates" ] }, { "slug": "website-reviews-social-desk", "name": "Website, Reviews and Social Desk", "url": "/website-reviews-social-desk/", "group": "AI tools", "status": "launch", "menu_line": "Checks your website and listings each week, and drafts review replies and monthly posts for your approval.", "price": "from $4,500 + $250 a month", "duration": "1 week", "entry": { "name": "Website and reviews check", "price": "$4,500", "duration": "1 week" }, "tiers": [ { "name": "One site", "price": "$4,500", "year_one": "$7,500" }, { "name": "Up to 15 sites", "price": "$9,500", "year_one": "$13,700" }, { "name": "Multi-site", "price": "from $14,500", "year_one": "$20,500–28,000" }, { "name": "Website and reviews check", "price": "$1,500 ($3,500 to cover all your locations)", "year_one": "$1,500 ($3,500 to cover all your locations)" } ], "run": "$250 a month for one location; $350 for up to 15; $500 multi-site", "runs_in": "ours", "segments": [ "practices", "health-centers", "post-acute", "health-tech" ], "patient_data": "none", "problem_stat_by_segment": { "practices": "ocr_reviews", "health-centers": "hrsa_target", "post-acute": "ocr_cadia", "health-tech": "pew_ai_summary" }, "problems": [ "hc-target", "pr-found", "pr-reviews", "pa-census", "ht-ai-answers" ] }, { "slug": "price-transparency-monitor", "name": "Price Transparency and Accessibility Monitor", "url": "/price-transparency-monitor/", "group": "AI tools", "status": "launch", "menu_line": "Checks your price file against your chargemaster, and your website against HHS's accessibility rule.", "price": "from $9,500 + $450 a month", "duration": "2–3 weeks", "entry": { "name": "Hospital audit", "price": "$9,500", "duration": "1 week" }, "tiers": [ { "name": "Hospital monitor", "price": "from $9,500", "year_one": "$14,900–23,400" }, { "name": "System monitor", "price": "from $32,000", "year_one": "$44,000–66,000" }, { "name": "Hospital audit", "price": "$3,500 ($7,500 to cover every website a health system runs)", "year_one": "$3,500 ($7,500 to cover every website a health system runs)" } ], "run": "$450 a month for a hospital; $1,000 to $1,500 for health system support", "runs_in": "mixed", "segments": [ "community-hospitals", "health-systems" ], "patient_data": "none", "problem_stat_by_segment": { "community-hospitals": "cfr_180_90", "health-systems": "cfr_180_90" }, "problems": [ "hs-web", "ch-price" ] }, { "slug": "contract-register", "name": "Payer and Vendor Contract Register", "url": "/contract-register/", "group": "AI tools", "status": "launch", "menu_line": "Pulls the deadlines and price terms from your payer and vendor contracts, with the page cited, and warns the person responsible for each contract 90 days before each date.", "price": "from $14,500 + $350–850 a month", "duration": "3–5 weeks", "entry": { "name": "First batch", "price": "$14,500", "duration": "1 to 2 weeks" }, "tiers": [ { "name": "Register", "price": "from $14,500", "year_one": "$18,700–34,200" }, { "name": "Health system", "price": "from $25,000", "year_one": "$34,000–54,400" }, { "name": "First batch", "price": "$6,500", "year_one": "$6,500" } ], "run": "$350 to $850 a month by contract count; $750 to $1,200 for a health system", "runs_in": "client", "segments": [ "community-hospitals", "health-systems", "post-acute", "health-tech" ], "patient_data": "none", "problem_stat_by_segment": { "community-hospitals": "aha_coc_supplies", "health-systems": "aha_coc_supplies", "post-acute": "senate_psi", "health-tech": "premier" }, "problems": [ "hs-costs", "hs-labor", "hs-denials", "ch-margins", "ch-staffing", "ch-payer", "pa-turnover", "pa-ma", "ht-denials" ] }, { "slug": "funding-desk", "name": "Funding and Needs Assessment Desk", "url": "/funding-desk/", "group": "AI tools", "status": "launch", "menu_line": "Finds the grants and rural funds you qualify for, and drafts application text from your own facts and figures.", "price": "from $9,500 + $300 a month", "duration": "2 weeks", "entry": { "name": "Application sprint", "price": "$9,500", "duration": "1 week" }, "tiers": [ { "name": "Weekly funding watch", "price": "$9,500", "year_one": "$13,100" }, { "name": "Needs assessment", "price": "from $10,500", "year_one": "$10,500–14,500" }, { "name": "Network", "price": "from $45,000", "year_one": "$45,000–70,000" }, { "name": "Application sprint", "price": "$5,500", "year_one": "$5,500" } ], "run": "$300 a month for the weekly watch, drafting support and the yearly refresh", "runs_in": "mixed", "segments": [ "community-hospitals", "health-centers", "health-systems" ], "patient_data": "none", "problem_stat_by_segment": { "community-hospitals": "kff_rht", "health-centers": "kff_chc_grants", "health-systems": "tax4959" }, "problems": [ "hs-chna", "ch-funding", "hc-cash", "hc-reporting" ] }, { "slug": "health-center-site-visit", "name": "Health Center Site Visit Readiness", "url": "/health-center-site-visit/", "group": "AI tools", "status": "launch", "menu_line": "Matches your documents to each HRSA requirement every month, so gaps show up before a site visit.", "price": "from $11,000 + $250 a month", "duration": "2–4 weeks", "entry": { "name": "Readiness scan", "price": "$11,000", "duration": "1 to 2 weeks" }, "tiers": [ { "name": "Checker", "price": "$11,000", "year_one": "$14,000" }, { "name": "Network", "price": "from $32,500", "year_one": "$44,500, for five centers" }, { "name": "Readiness scan", "price": "$6,500", "year_one": "$6,500" } ], "run": "$250 a month for one center; $200 a center a month in a network", "runs_in": "client", "segments": [ "health-centers" ], "patient_data": "none", "problem_stat_by_segment": { "health-centers": "hrsa_osv_top5" }, "problems": [ "hc-compliance" ] }, { "slug": "nursing-home-survey-readiness", "name": "Nursing Home Survey Readiness", "url": "/nursing-home-survey-readiness/", "group": "AI tools", "status": "launch", "menu_line": "Ranks the federal requirements (tags) your building is most likely to be cited on, from public CMS inspection data, then keeps your evidence current.", "price": "from $6,500 + $250 a month", "duration": "1 week", "entry": { "name": "Survey risk scan", "price": "$6,500", "duration": "1 week" }, "tiers": [ { "name": "Scan and watch", "price": "$6,500", "year_one": "$9,500" }, { "name": "Readiness checker", "price": "from $20,000", "year_one": "$25,400, for one building" }, { "name": "Survey risk scan", "price": "$6,500", "year_one": "$6,500" } ], "run": "$250 a month for the quarterly watch; $450 a building a month for the checker, $250 at 10 or more", "runs_in": "mixed", "segments": [ "post-acute" ], "patient_data": "none", "problem_stat_by_segment": { "post-acute": "cms_nh_fines" }, "problems": [ "pa-survey" ] }, { "slug": "custom-ai-tool", "name": "Custom AI Tool", "url": "/custom-ai-tool/", "group": "AI tools", "status": "launch", "menu_line": "A tool built around your own workflow, for work no other service on the menu covers.", "price": "from $9,500 + $450 a month", "duration": "2–3 weeks", "entry": { "name": "Credentialing file audit", "price": "$9,500", "duration": "1 week" }, "tiers": [ { "name": "Small tool", "price": "$9,500", "year_one": "$14,900" }, { "name": "Full build", "price": "from $25,000", "year_one": "$30,400–78,000" }, { "name": "Credentialing file audit", "price": "$1,500 (up to 8 clinicians) or $3,500 (up to 25)", "year_one": "$1,500 (up to 8 clinicians) or $3,500 (up to 25)" } ], "run": "$450 to $1,500 a month for support, by size, or nothing if your team takes it over", "runs_in": "client", "segments": [ "health-systems", "community-hospitals", "health-centers", "practices", "post-acute", "health-tech" ], "patient_data": "none-today; patient-data builds after a BAA", "problem_stat_by_segment": {}, "problems": [ "hs-regulatory", "hs-research", "ch-payer", "ch-credentialing", "hc-coverage", "hc-language", "pr-payment", "pr-credentialing", "pa-documentation", "pa-census", "ht-credentialing", "ht-selling", "ht-rules" ] }, { "slug": "labor-retention-desk", "name": "Contract Labor and Retention Desk", "url": null, "group": "AI tools", "status": "not-on-menu", "menu_line": "Agency and overtime spend by unit, agency invoices checked against rates and timecards, and which units lose new hires in their first 90 days.", "runs_in": "client", "segments": [ "community-hospitals", "health-systems", "post-acute", "health-centers" ], "patient_data": "none (employee data under HR access rules)", "problems": [ "hs-labor", "ch-staffing", "hc-turnover", "pa-turnover" ] }, { "slug": "medicaid-renewal-kit", "name": "Medicaid Renewal Readiness Kit", "url": null, "group": "AI tools", "status": "not-on-menu", "menu_line": "Outreach templates in your patients' languages, a state exemption checklist and a staff workflow for Medicaid renewals and the new work requirements.", "runs_in": "client", "segments": [ "health-centers", "community-hospitals" ], "patient_data": "none in the kit (the center builds the worklist in its own EHR reporting); the full desk needs PHI and a BAA", "problems": [ "hc-coverage" ] }, { "slug": "market-share-watcher", "name": "Market Share and Outmigration Watcher", "url": null, "group": "AI tools", "status": "not-on-menu", "menu_line": "Updates the ZIP code map each year when CMS posts its new file, and shows each quarter which referring physicians went quiet.", "runs_in": "mixed", "segments": [ "community-hospitals" ], "patient_data": "none (CMS public file plus the hospital's referral counts by physician)", "problems": [ "ch-bypass" ] }, { "slug": "hospital-survey-readiness", "name": "Hospital Policy Library and Survey Readiness", "url": null, "group": "AI tools", "status": "not-on-menu", "menu_line": "Cleans up the duplicate and conflicting policies left when policy libraries are merged.", "runs_in": "client", "segments": [ "health-systems", "community-hospitals" ], "patient_data": "none", "problems": [ "hs-regulatory" ] }, { "slug": "client-results-report", "name": "Client Results Report", "url": null, "group": "AI tools", "status": "not-on-menu", "menu_line": "A quarterly results brief for each client, with a methods page.", "runs_in": "client", "segments": [ "health-tech" ], "patient_data": "aggregate only; the vendor computes member metrics, and member-level matching needs a BAA", "problems": [ "ht-results" ] }, { "slug": "denial-desk", "name": "Denial and Appeals Desk", "url": null, "group": "AI tools", "status": "after-baa", "menu_line": "Groups denials by cause and drafts appeals.", "runs_in": "client", "segments": [ "community-hospitals", "health-systems", "post-acute", "health-tech" ], "patient_data": "PHI (claims and remittances)", "problems": [ "hs-denials", "ch-payer", "pr-denials", "pa-ma", "ht-denials" ] }, { "slug": "discharge-placement-desk", "name": "Discharge Delay and Post-Acute Placement Desk", "url": null, "group": "AI tools", "status": "after-baa", "menu_line": "Patients waiting on a post-acute bed, the referrals each one needs and which facilities answered, in one daily list for case management.", "runs_in": "client", "segments": [ "health-systems", "community-hospitals" ], "patient_data": "PHI", "problems": [ "hs-capacity" ] }, { "slug": "practice-back-office-inbox", "name": "Practice Back-Office Inbox", "url": null, "group": "AI tools", "status": "after-baa", "menu_line": "Sorts the practice inbox and fax queue, drafts each reply and routes each item to the right person, with one-tap approval.", "runs_in": "client", "segments": [ "practices" ], "patient_data": "PHI (patient messages, payer letters and faxes)", "problems": [ "pr-pa" ] }, { "slug": "referral-intake-desk", "name": "Home Health Referral Intake Desk", "url": null, "group": "AI tools", "status": "after-baa", "menu_line": "Pulls each faxed referral packet into your intake form, flags missing documents and tracks time to answer, for your intake nurse to decide.", "runs_in": "client", "segments": [ "post-acute" ], "patient_data": "PHI (referral packets)", "problems": [ "pa-referrals" ] }, { "slug": "hospice-cap-monitor", "name": "Hospice Cap Monitor", "url": null, "group": "AI tools", "status": "after-baa", "menu_line": "Tracks patient days and payments against Medicare's hospice cap each month, so the CFO sees a projected overage while the census can still change.", "runs_in": "client", "segments": [ "post-acute" ], "patient_data": "PHI (patient-level days and payments)", "problems": [ "pa-hospice" ] } ], "existing_offers": { "throughput-diagnostic": { "name": "Throughput Diagnostic", "price": "$14,500", "duration": "3 weeks", "menu_line": "Finds the one step causing your discharge delays, ED boarding or OR backlog, and puts a dollar cost on each day of delay.", "url": "/throughput-diagnostic/" }, "capacity-forecast": { "name": "Capacity and Staffing Forecast", "price": "from $14,500", "duration": "4–6 weeks", "menu_line": "Forecasts how many patients each unit will have from your own hourly counts, tested before anyone relies on it.", "url": "/capacity-forecast/" }, "analytics-build": { "name": "Data Warehouse and Reporting", "price": "$25k–60k", "duration": "4–10 weeks", "menu_line": "One warehouse with agreed definitions, and reports such as UDS that refresh on schedule.", "url": "/analytics-build/" }, "ai-governance": { "name": "AI Governance Starter", "price": "$8,500", "duration": "3 weeks", "menu_line": "An AI inventory, an AI use policy, risk tiers and a vendor checklist.", "url": "/ai-governance/" }, "predictive-model": { "name": "Predictive Models", "price": "$18k–35k", "duration": "4–6 weeks", "menu_line": "No-show, readmission or renewal risk, scored where staff already work.", "url": "/predictive-model/" }, "outcomes-study": { "name": "Outcomes and ROI Study", "price": "$15k–30k", "duration": "3–6 weeks", "menu_line": "Whether a program worked, measured against a matched comparison group.", "url": "/outcomes-study/" }, "data-visualization": { "name": "Data Visualization and Dashboards", "price": "$15k–40k", "duration": "3–8 weeks", "menu_line": "Dashboards people use, interactive data stories and report graphics.", "url": "/data-visualization/" }, "vendor-evaluation": { "name": "AI Vendor Evaluation", "price": "$7,500–9,500", "duration": "2 weeks", "menu_line": "Each vendor on your shortlist tested on cases from your own organization, with its three-year cost and how it would handle your data in writing.", "url": "/vendor-evaluation/" }, "training": { "name": "AI Staff Training", "price": "$1,800–12,000", "duration": "90 min to 4 weeks", "menu_line": "Live sessions for leaders, daily users and skeptics, from a briefing to four weeks.", "url": "/training/" } }, "stats": { "ada_busy": { "id": "ada_busy", "value": "About a quarter", "claim": "About a quarter of dentists said they were not busy enough in the second quarter of 2026.", "source_name": "ADA Health Policy Institute, The State of the US Dental Economy, Q2 2026", "url": "https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/state_us_dental_economy_q22026.pdf", "quote": "In Q2 2026, around one-quarter of dentists reported that they were not busy enough", "year": "Q2 2026", "population": "552 dentists in private practice" }, "aha_coc_supplies": { "id": "aha_coc_supplies", "value": "9.9%", "claim": "Hospital spending on supplies rose 9.9% in 2025 and drug spending 13.6%, against 7.5% growth in total expenses.", "source_name": "AHA, Costs of Caring 2026 (Strata Decision Technology benchmark data)", "url": "https://www.aha.org/system/files/media/file/2026/03/Costs-of-Caring-2026.pdf", "quote": "Total spending on supplies increased 9.9% through 2025", "year": "2025 data, published March 2026", "population": "US hospitals (Strata benchmark data)", "also": [ { "url": "https://www.aha.org/system/files/media/file/2026/03/Costs-of-Caring-2026.pdf", "quote": "Hospital drug expenses increased 13.6% in 2025" }, { "url": "https://www.aha.org/system/files/media/file/2026/03/Costs-of-Caring-2026.pdf", "quote": "in 2025, total hospital expenses grew 7.5%" } ] }, "aha_coc_workforce": { "id": "aha_coc_workforce", "value": "5.6%", "claim": "Hospital workforce costs rose 5.6% in 2025 as hospitals raised wages to recruit and keep staff.", "source_name": "AHA, Costs of Caring 2026 (Strata Decision Technology benchmark data)", "url": "https://www.aha.org/system/files/media/file/2026/03/Costs-of-Caring-2026.pdf", "quote": "In 2025, workforce costs rose 5.6% as hospitals increased wages to recruit and retain nurses, physicians and other staff", "year": "2025 data, published March 2026", "population": "US hospitals (Strata benchmark data; AHA notes its labor figure includes purchased services)" }, "aha_discharge": { "id": "aha_discharge", "value": "Nearly 24%", "claim": "Hospital stays for patients discharged to post-acute care grew nearly 24% longer from 2019 to 2022.", "source_name": "AHA Issue Brief, Patients and Providers Faced with Increasing Delays in Timely Discharges (Strata data)", "url": "https://www.aha.org/system/files/media/file/2022/12/Issue-Brief-Patients-and-Providers-Faced-with-Increasing-Delays-in-Timely-Discharges.pdf", "quote": "with an increase in ALOS of nearly 24% from 2019 to 2022", "year": "December 2022 (2019 to 2022 data)", "population": "US hospitals (Strata data cited by AHA)" }, "aha_expenses": { "id": "aha_expenses", "value": "7.5%", "claim": "Total hospital expenses grew 7.5% in 2025; drug costs grew 13.6%.", "source_name": "AHA, Hospitals Face Increased Costs of Caring for Patients (March 2026)", "url": "https://www.aha.org/news/perspective/2026-03-13-hospitals-face-increased-costs-caring-patients", "quote": "In 2025, total hospital expenses grew 7.5%", "year": "2025 data", "population": "US hospitals" }, "aha_ff": { "id": "aha_ff", "value": "5,121", "claim": "There are 5,121 US community hospitals; 1,797 are rural and 3,567 belong to a system.", "source_name": "AHA, Fast Facts on US Hospitals, 2026", "url": "https://www.aha.org/statistics/fast-facts-us-hospitals", "quote": "Number of U.S. Community 1 Hospitals 5,121", "year": "2024 AHA Annual Survey", "population": "US hospitals" }, "aha_ma_rural": { "id": "aha_ma_rural", "value": "90.6%", "claim": "Medicare Advantage plans paid rural hospitals 90.6% of traditional Medicare rates on a cost basis.", "source_name": "AHA, The Growing Impact of Medicare Advantage on Rural Hospitals Across America", "url": "https://www.aha.org/guidesreports/growing-impact-medicare-advantage-rural-hospitals-across-america", "quote": "only 90.6% of Traditional Medicare rates on a cost basis", "year": "2023 data (Strata), published February 2025", "population": "US rural hospitals" }, "aha_reg": { "id": "aha_reg", "value": "$7.6 million", "claim": "An average-sized community hospital (161 beds) spent nearly $7.6 million a year on the administrative work of complying with federal rules in the nine areas the study reviewed, and had the equivalent of 59 full-time staff on regulatory compliance. The study counted 341 federal requirements for hospitals and 288 more for post-acute care.", "source_name": "AHA, Regulatory Overload, October 2017", "url": "https://www.aha.org/system/files/2018-02/regulatory-overload-report.pdf", "quote": "An average-sized community hospital (161 beds) spends nearly $7.6 million annually on administrative activities to support compliance with the reviewed federal regulations", "year": "2017", "population": "Survey of 190 hospitals, plus interviews with 33 executives at four health systems", "also": [ { "quote": "These include 341 hospital-related requirements and 288 PAC-related requirements." }, { "quote": "While an average size community hospital dedicates 59 FTEs overall, PAC regulations require an additional 8.1 FTEs." } ] }, "aks": { "id": "aks", "value": "Anti-kickback", "claim": "Federal law makes it a felony to knowingly and willfully offer or pay anything of value, in cash or in kind, to induce referrals of patients covered by a federal health care program, unless one of the law's exceptions applies.", "source_name": "42 U.S.C. 1320a-7b(b) (Cornell LII)", "url": "https://www.law.cornell.edu/uscode/text/42/1320a-7b", "quote": "in cash or in kind to any person to induce such person", "year": "Current statute", "population": "Anyone paying or receiving referral inducements", "also": [ { "url": "https://www.law.cornell.edu/uscode/text/42/1320a-7b", "quote": "Whoever knowingly and willfully offers or pays any remuneration" }, { "url": "https://www.law.cornell.edu/uscode/text/42/1320a-7b", "quote": "shall be guilty of a felony" }, { "url": "https://www.law.cornell.edu/uscode/text/42/1320a-7b", "quote": "Paragraphs (1) and (2) shall not apply to" } ] }, "ama_medicare33": { "id": "ama_medicare33", "value": "33%", "claim": "Medicare physician pay fell 33% from 2001 to 2025 after adjusting for inflation.", "source_name": "AMA, Medicare physician pay has plummeted since 2001", "url": "https://www.ama-assn.org/practice-management/medicare-medicaid/medicare-physician-pay-has-plummeted-2001-find-out-why", "quote": "Doctors are paid 33% less today, when adjusted for inflation.", "year": "April 2025", "population": "Medicare physician fee schedule" }, "ama_pa": { "id": "ama_pa", "value": "40 a week", "claim": "Physicians complete an average of 40 prior authorizations a week, taking 13 hours of physician and staff time.", "source_name": "AMA, 2025 prior authorization physician survey (press release)", "url": "https://www.ama-assn.org/press-center/ama-press-releases/ama-survey-prior-authorization-reform-pledge-falls-short-physicians", "quote": "Physicians complete an average of 40 prior authorizations per week", "year": "Survey December 2025, released May 2026", "population": "1,000 practicing physicians", "also": [ { "quote": "Prior authorization consumes an average of 13 hours of physician and staff time each week" } ] }, "bls_medsec": { "id": "bls_medsec", "value": "$22.08", "claim": "The median hourly wage for medical secretaries and administrative assistants was $22.08 in May 2025; for medical and health services managers it was $59.55.", "source_name": "Bureau of Labor Statistics, May 2025 median wages: medical secretaries and administrative assistants; medical and health services managers", "url": "https://api.bls.gov/publicAPI/v2/timeseries/data/OEUN000000000000043601308", "quote": "2025 annual value 22.08 (43-6013); 59.55 (11-9111)", "year": "May 2025", "population": "US employment, all industries", "method": "api", "also": [ { "url": "https://api.bls.gov/publicAPI/v2/timeseries/data/OEUN000000000000011911108", "in_name": "medical and health services managers", "name": "BLS series for medical and health services managers", "quote": "\"year\":\"2025\",\"period\":\"A01\",\"periodName\":\"Annual\",\"latest\":\"true\",\"value\":\"59.55\"" } ] }, "bls_medsec_year": { "id": "bls_medsec_year", "value": "$34,000", "claim": "Thirty hours a week of a medical secretary's time costs about $34,000 a year at the median wage of $22.08 an hour in May 2025 (30 hours × 52 weeks × $22.08).", "source_name": "Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025", "url": "https://api.bls.gov/publicAPI/v2/timeseries/data/OEUN000000000000043601308", "quote": "2025 annual value 22.08 (43-6013)", "year": "May 2025", "population": "US employment, all industries", "method": "computed" }, "bowblis_agency": { "id": "bowblis_agency", "value": "Almost half", "claim": "By 2022, almost half of nursing homes used agency nursing staff, up from 23% in 2018.", "source_name": "Bowblis et al., Nursing Homes Increasingly Rely On Staffing Agencies For Direct Care Nursing, Health Affairs", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10955789/", "quote": "By 2022, almost half of all nursing homes used agency staff, accounting for 11 percent of all direct care nursing staff hours.", "year": "2024 (data for 2018 to 2022)", "population": "US nursing homes", "also": [ { "quote": "In 2018, 23 percent of nursing homes used agency nursing staff, accounting for about 3 percent of all direct care nursing hours worked." } ] }, "bullhorn": { "id": "bullhorn", "value": "77%", "claim": "77% of healthcare staffing recruiters spend at least an hour a day on manual credentialing; 37% spend three hours or more.", "source_name": "Bullhorn, GRID 2026 Industry Trends Report: Healthcare spotlight (a staffing software vendor's survey)", "url": "https://www.bullhorn.com/grid/grid-2026-industry-trends-report-healthcare-spotlight/", "quote": "Seventy-seven percent of healthcare recruiters spend at least one hour daily on manual credentialing tasks", "year": "Survey November to December 2025", "population": "Nearly 200 healthcare staffing leaders and recruiters in North America", "also": [ { "url": "https://www.bullhorn.com/news-and-press/press-releases/bullhorn-grid-report-staffing-firms-using-ai-see-stronger-growth-faster-placements/", "name": "Bullhorn's release on the survey dates", "quote": "The survey was conducted between November and December of 2025." } ] }, "ca_ab3030": { "id": "ca_ab3030", "value": "Disclaimer", "claim": "California requires a disclaimer and a way to reach a human on AI-generated patient communications about clinical information, unless a licensed or certified health care provider reads and reviews the communication.", "source_name": "California AB 3030 (2024), legislative counsel's digest", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB3030", "quote": "The bill would exempt from this requirement a communication read and reviewed by a human licensed or certified health care provider", "year": "Chaptered 2024; Health and Safety Code 1339.75", "population": "California health facilities, clinics and physician offices" }, "ca_ads": { "id": "ca_ads", "value": "October 1, 2025", "claim": "California's Civil Rights Council rules on automated decision systems in employment took effect October 1, 2025.", "source_name": "California Civil Rights Council, rulemaking actions page", "url": "https://calcivilrights.ca.gov/civilrightscouncil/rulemaking-actions/", "quote": "were filed with the Secretary of State on June 27, 2025. The effective date of the regulations is October 1, 2025", "year": "Effective October 1, 2025", "population": "California employers" }, "caqh_120": { "id": "caqh_120", "value": "120 days", "claim": "Clinicians with a CAQH provider profile must re-attest it every 120 days (every 180 days in Illinois), or the profile expires; the platform is free to clinicians and practices.", "source_name": "DataSpring (CAQH), provider FAQ", "url": "https://www.dataspring.com/resources", "quote": "they are still required to attest to their data profiles every 120 days (every 180 days for IL providers) to comply with credentialing requirements", "year": "Page as of October 2026", "population": "CAQH users", "also": [ { "url": "https://www.dataspring.com/resources", "quote": "If providers do not attest within the required timeframe, their CAQH Provider Data Portal status will be changed to Expired." }, { "url": "https://www.caqh.org/providers", "name": "CAQH clinician page", "quote": "provide the platform at no cost to clinicians, provider groups, and practices" }, { "url": "https://caqh.org/solutions/caqh-proview-dental-faqs", "name": "CAQH dental FAQ", "quote": "review and attest to their information every 120 days" } ] }, "carescout_al": { "id": "carescout_al", "value": "$74,400", "claim": "The national median cost of assisted living was $6,200 a month, or $74,400 a year, in 2025.", "source_name": "CareScout, Cost of Care Survey 2025", "url": "https://www.carescout.com/cost-of-care", "quote": "The national median monthly cost for assisted living communities increased 5% to $6,200 per month, or $74,400 annually.", "year": "2025", "population": "About 16,000 surveys of US long-term care providers" }, "census_practices": { "id": "census_practices", "value": "92.3%", "claim": "There are 440,667 physician, dentist, other health practitioner and outpatient mental health firms with employees, and 92.3% of them have fewer than 20 employees.", "source_name": "US Census Bureau, Statistics of US Businesses 2022", "url": "https://www2.census.gov/programs-surveys/susb/tables/2022/us_state_6digitnaics_2022.txt", "quote": "US rows, NAICS 6211, 6212, 6213 and 621420: total firms 440,667; firms under 20 employees 406,615 (sum of published rows)", "year": "2022", "population": "US employer firms", "method": "computed" }, "cfr_180_90": { "id": "cfr_180_90", "value": "$11 a bed", "claim": "CMS can fine a hospital with 31 to 550 beds up to $11 per bed per day for breaking the price transparency rules: up to $1,980 a day at 180 beds, about $723,000 a year. Smaller hospitals face up to $342 a day and larger ones up to $6,277. HHS adjusts these maximums for inflation every year.", "source_name": "45 CFR 180.90 and 45 CFR 102.3 (eCFR)", "url": "https://www.ecfr.gov/current/title-45/section-102.3", "quote": "45 CFR 180.90(c)(2)(ii)(A) CMS Per day penalty for hospitals with equal to or less than 30 beds 2024 333 342", "year": "2025 maximums, adjusted for inflation", "population": "US hospitals", "also": [ { "url": "https://www.ecfr.gov/current/title-45/section-102.3", "quote": "45 CFR 180.90(c)(2)(ii)(B) CMS Per day, per bed penalty for hospitals having at least 31 and up to and including 550 beds 2024 11 11" }, { "url": "https://www.ecfr.gov/current/title-45/section-102.3", "quote": "45 CFR 180.90(c)(2)(ii)(C) CMS Per day penalty for hospitals having greater than 550 beds 2024 6,118 6,277" }, { "url": "https://www.ecfr.gov/current/title-45/section-102.3", "quote": "The civil monetary penalty amounts are adjusted annually." }, { "url": "https://www.ecfr.gov/current/title-45/section-180.90", "quote": "adjusted annually using the multiplier determined by OMB for annually adjusting civil monetary penalty amounts under part 102 of this title" } ] }, "chartis": { "id": "chartis", "value": "41.2%", "claim": "The median rural hospital runs a 2.0% operating margin, and 41.2% of rural hospitals operate in the red.", "source_name": "Chartis, 2026 Rural Health State of the State", "url": "https://www.chartis.com/insights/2026-rural-health-state-state", "quote": "The national median operating margin for rural hospitals is 2.0%, with 41.2% of all rural hospitals operating in the red.", "year": "Medicare cost report data through Q3 2025", "population": "US rural hospitals" }, "cms_0057f": { "id": "cms_0057f", "value": "January 1, 2027", "claim": "Medicare Advantage, Medicaid, CHIP and federal marketplace plans must run a prior authorization API that lists covered items and services and their documentation requirements, beginning January 1, 2027.", "source_name": "CMS fact sheet, Interoperability and Prior Authorization final rule (CMS-0057-F)", "url": "https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-prior-authorization-final-rule-cms-0057-f", "quote": "Prior Authorization API that is populated with its list of covered items and services, can identify documentation requirements for prior authorization approval", "year": "Final rule January 2024; API due January 1, 2027", "population": "Impacted payers (MA, Medicaid, CHIP, FFE marketplace plans)", "also": [ { "url": "https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-prior-authorization-final-rule-cms-0057-f", "quote": "This requirement must be implemented beginning January 1, 2027" } ] }, "cms_appx_pp": { "id": "cms_appx_pp", "value": "F880", "claim": "In the guidance CMS gives nursing home surveyors, tag F880 is the infection control requirement, 42 CFR 483.80.", "source_name": "CMS, State Operations Manual, Appendix PP: Guidance to Surveyors for Long Term Care Facilities", "url": "https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/downloads/appendix-pp-state-operations-manual.pdf", "quote": "F880 (Rev. 225; Issued: 08-08-24; Effective: 08-08-24; Implementation: 08-08-24) §483.80 Infection Control", "year": "Page as of October 2026", "population": "Medicare and Medicaid nursing homes" }, "cms_bypass": { "id": "cms_bypass", "value": "32%", "claim": "32% of rural Medicare beneficiaries with a hospital stay went at least once to a more distant hospital for inpatient care their local hospital also offered, which a CMS study counts as an avoidable bypass.", "source_name": "CMS Office of Minority Health, Examining Rural Hospital Bypass for Inpatient Services", "url": "https://www.cms.gov/files/document/ruralhospitalbypassfinalreport.pdf", "quote": "one-third of beneficiaries (32 percent) had at least one avoidable bypass in CY 2018", "year": "CY 2018 data, published December 2020", "population": "Rural Medicare fee-for-service beneficiaries with inpatient stays" }, "cms_ce_2027": { "id": "cms_ce_2027", "value": "January 1, 2027", "claim": "States must generally start Medicaid work requirements for expansion adults no later than January 1, 2027.", "source_name": "CMS fact sheet, Medicaid Community Engagement Requirement interim final rule", "url": "https://www.cms.gov/newsroom/fact-sheets/medicaid-community-engagement-requirement-certain-individuals-interim-final-rule-comment-period-cms", "quote": "States must generally implement this requirement no later than January 1, 2027", "year": "June 2026", "population": "Medicaid expansion adults aged 19 to 64" }, "cms_cert_snf": { "id": "cms_cert_snf", "value": "$4.3 billion", "claim": "CMS projects $4.3 billion of improper payments for skilled nursing services in its 2025 report, an 11.8% rate, led by insufficient documentation.", "source_name": "CMS, 2025 Medicare Fee-for-Service Supplemental Improper Payment Data", "url": "https://www.cms.gov/files/document/nov-2025-medicare-ffs-supplemental-improper-payment-data-2025922.pdf", "quote": "The projected improper payment amount for SNF services during the 2025 report period was $4.3 billion, resulting in an improper payment rate of 11.8 percent.", "year": "2025 report period", "population": "Medicare fee-for-service SNF claims" }, "cms_hhvbp": { "id": "cms_hhvbp", "value": "-5% to +5%", "claim": "Under the expanded Home Health Value-Based Purchasing Model, each agency's Medicare fee-for-service payments move by between -5% and +5% based on its quality performance; 2025 was the first payment year.", "source_name": "CMS, Expanded Home Health Value-Based Purchasing Model", "url": "https://www.cms.gov/priorities/innovation/innovation-models/expanded-home-health-value-based-purchasing-model", "quote": "an applicable percent ranging from -5% to 5% applies toward Medicare fee-for-service payments", "year": "Payment years from CY 2025 (CY 2023 performance)", "population": "Medicare-certified home health agencies" }, "cms_hpt_validator": { "id": "cms_hpt_validator", "value": "Format check", "claim": "CMS's free price transparency validator tests a machine-readable file against the CMS template and data specifications. It doesn't compare the prices with the hospital's own records.", "source_name": "CMS, Hospital Price Transparency resources page", "url": "https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/resources", "quote": "a Validator that tests against the required CMS template and data specifications", "year": "Page as of October 2026", "population": "Hospital machine-readable files", "also": [ { "url": "https://www.cms.gov/files/document/hospital-price-transparency-validator-faqs.pdf", "name": "CMS validator FAQs, January 8, 2025", "quote": "The validator tool tests hospital machine-readable files against the required CMS template layout and data dictionary technical specifications" } ] }, "cms_hsa": { "id": "cms_hsa", "value": "CY 2025", "claim": "CMS's Hospital Service Area file counts Medicare fee-for-service and Medicare Advantage inpatient discharges, days and charges by hospital and patient ZIP code.", "source_name": "CMS, Hospital Service Area dataset (data.cms.gov catalog entry)", "url": "https://data.cms.gov/provider-summary-by-type-of-service/medicare-inpatient-hospitals/hospital-service-area", "quote": "summarized by hospital provider number and the ZIP code of the Medicare beneficiary", "year": "Calendar 2025 data, modified July 6, 2026", "population": "Medicare inpatient discharges (FFS and MA)", "also": [ { "url": "https://data.cms.gov/data.json", "quote": "\"modified\": \"2026-07-06\"" } ] }, "cms_nh_fines": { "id": "cms_nh_fines", "value": "44.3%", "claim": "44.3% of US nursing homes were fined at least once in the last three years, and among those homes the median total in fines was $33,594.", "source_name": "CMS Provider Data Catalog, Nursing Home Provider Information and Penalties (September 2026 files)", "url": "https://data.cms.gov/provider-data/dataset/4pq5-n9py", "quote": "Computed: 6,510 of 14,690 homes have one or more fines in the 'Number of Fines' column; median of 'Total Amount of Fines in Dollars' among them is $33,594", "year": "Penalties September 2023 to August 2026 (file modified September 30, 2026)", "population": "14,690 Medicare- and Medicaid-certified nursing homes", "method": "computed", "also": [ { "url": "https://data.cms.gov/provider-data/dataset/g6vv-u9sr", "name": "CMS Penalties dataset", "in_name": "Penalties", "quote": "A list of the fines and payment denials received by nursing homes in the last three years." } ] }, "cmwf_referrals": { "id": "cmwf_referrals", "value": "59%", "claim": "Among hospitalized Medicare patients referred to home health, the share who received it fell from 66% in 2016 to 59% in 2022.", "source_name": "Commonwealth Fund, Fewer Hospitalized Medicare Beneficiaries Are Receiving Recommended Home Health Care", "url": "https://www.commonwealthfund.org/blog/2024/fewer-hospitalized-medicare-beneficiaries-are-receiving-recommended-home-health-care", "quote": "Overall home health referral fulfillment rates decreased from 66 percent to 59 percent between 2016 and 2022", "year": "2024 (2016 to 2022 data)", "population": "Hospitalized Medicare beneficiaries" }, "ecfr_424_44": { "id": "ecfr_424_44", "value": "1 year", "claim": "Medicare claims must generally be filed within one calendar year after the date of service.", "source_name": "42 CFR 424.44 (eCFR)", "url": "https://www.ecfr.gov/current/title-42/section-424.44", "quote": "the claim must be filed no later than the close of the period ending 1 calendar year after the date of service", "year": "Current rule", "population": "Medicare claims" }, "ecfr_485_616": { "id": "ecfr_485_616", "value": "Written agreement", "claim": "A critical access hospital that relies on another hospital's credentialing for telemedicine physicians needs a written agreement, each physician's current privilege list and state license, and must send back performance information, including all adverse events and complaints.", "source_name": "42 CFR 485.616(c) (eCFR); 42 CFR 482.22(a)(3) has the same terms for other hospitals", "url": "https://www.ecfr.gov/current/title-42/section-485.616", "quote": "the CAH has evidence of an internal review of the distant-site physician's or practitioner's performance of these privileges and sends the distant-site hospital such information", "year": "Current rule", "population": "Critical access hospitals using telemedicine", "also": [ { "url": "https://www.ecfr.gov/current/title-42/section-482.22", "name": "42 CFR 482.22", "quote": "sends the distant-site hospital such performance information for use in the periodic appraisal" } ] }, "ecfr_504": { "id": "ecfr_504", "value": "May 11, 2027", "claim": "HHS-funded organizations with 15 or more employees must meet WCAG 2.1 AA for web content and mobile apps from May 11, 2027; smaller ones from May 10, 2028.", "source_name": "45 CFR 84.84 (eCFR, as amended at 91 FR 25507)", "url": "https://www.ecfr.gov/current/title-45/section-84.84", "quote": "Beginning May 11, 2027, a recipient with fifteen or more employees shall ensure that the web content and mobile apps", "year": "Current rule (amended May 11, 2026)", "population": "Recipients of HHS financial assistance" }, "ecfr_92_201": { "id": "ecfr_92_201", "value": "Human review", "claim": "Under the Section 1557 rule, machine translation of critical or technical health content must be reviewed by a qualified human translator.", "source_name": "45 CFR 92.201(c)(3) (eCFR)", "url": "https://www.ecfr.gov/current/title-45/section-92.201", "quote": "the translation must be reviewed by a qualified human translator", "year": "Current rule", "population": "Covered health programs and activities" }, "ecfr_92_4": { "id": "ecfr_92_4", "value": "Covered entity", "claim": "Under 45 CFR part 92, a covered entity is a recipient of federal financial assistance, HHS itself, or an entity established under title I of the Affordable Care Act.", "source_name": "45 CFR 92.4 (eCFR)", "url": "https://www.ecfr.gov/current/title-45/section-92.4", "quote": "Covered entity means: (1) A recipient of Federal financial assistance; (2) The Department; and (3) An entity established under title I of the ACA.", "year": "Current rule", "population": "Health programs and activities covered by Section 1557" }, "far_micro": { "id": "far_micro", "value": "$15,000", "claim": "The federal micro-purchase threshold is $15,000. A purchase charged to a federal award at or under it can be made without competing quotes if the price is documented as reasonable, and a recipient may self-certify a threshold up to $50,000.", "source_name": "48 CFR 2.101 and 2 CFR 200.320 (eCFR, as of October 7, 2026)", "url": "https://www.ecfr.gov/current/title-48/section-2.101", "quote": "Micro-purchase threshold means $15,000", "year": "October 7, 2026", "population": "Purchases charged to federal awards", "also": [ { "url": "https://www.ecfr.gov/current/title-2/section-200.320", "in_name": "2 CFR 200.320", "quote": "may be awarded without soliciting competitive price or rate quotations" }, { "url": "https://www.ecfr.gov/current/title-2/section-200.320", "quote": "may self-certify a threshold up to $50,000" }, { "url": "https://www.ecfr.gov/current/title-2/section-200.320", "quote": "The aggregate amount of the procurement transaction does not exceed the micro-purchase threshold" } ] }, "fr_hh2026": { "id": "fr_hh2026", "value": "-1.3%", "claim": "Medicare cut aggregate home health payments 1.3% ($220 million) for 2026.", "source_name": "CMS, CY 2026 Home Health PPS final rule, Federal Register 2025-21767", "url": "https://www.federalregister.gov/documents/2025/12/02/2025-21767/medicare-and-medicaid-programs-calendar-year-2026-home-health-prospective-payment-system-hh-pps-rate", "quote": "estimated to be -$220 million (-1.3 percent)", "year": "CY 2026", "population": "Medicare home health agencies" }, "fr_pfs": { "id": "fr_pfs", "value": "716 pages", "claim": "The CY 2027 Medicare physician fee schedule proposed rule ran 716 Federal Register pages and drew 44,346 public comments.", "source_name": "Federal Register API, document 2026-14327", "url": "https://www.federalregister.gov/api/v1/documents/2026-14327.json", "quote": "page_length: 716; regulations_dot_gov_info.comments_count: 44346 (checked by the Federal Register 2026-09-30)", "year": "Published July 16, 2026", "population": "One proposed rule", "method": "api" }, "fr_uds": { "id": "fr_uds", "value": "184.2 hours", "claim": "HRSA estimates the annual UDS report takes 184.2 staff hours per health center.", "source_name": "HRSA, UDS information collection notice, Federal Register 2026-12046", "url": "https://www.govinfo.gov/content/pkg/FR-2026-06-16/html/2026-12046.htm", "quote": "1,596.00 1.00 1,596.00 184.20 293,983.20", "year": "2026 reporting year", "population": "UDS respondents" }, "ftc_doj_wages": { "id": "ftc_doj_wages", "value": "Jan 2025", "claim": "Exchanging pay information with competing employers can violate antitrust law, even when a third party or an algorithm does the exchanging.", "source_name": "DOJ and FTC, Antitrust Guidelines for Business Activities Affecting Workers (January 2025)", "url": "https://www.ftc.gov/system/files/ftc_gov/pdf/p251201antitrustguidelinesbusinessactivitiesaffectingworkers2025.pdf", "quote": "Exchanging such information with competitors may be illegal even if companies use a third party or intermediary", "year": "January 2025", "population": "Employers competing for workers" }, "gartner_dwx": { "id": "gartner_dwx", "value": "47%", "claim": "47% of employees who use computers and software for their work struggle to find the information or data they need to do their jobs well. The average desk worker used 11 software applications, up from six in 2019.", "source_name": "Gartner, Digital Worker Experience Survey", "url": "https://www.gartner.com/en/newsroom/press-releases/2023-05-10-gartner-survey-reveals-47-percent-of-digital-workers-struggle-to-find-the-information-needed-to-effectively-perform-their-jobs", "quote": "47% of digital workers struggle to find information or data needed to effectively perform their jobs", "year": "2023 (survey conducted September to November 2022)", "population": "4,861 full-time employees at organizations with 100 or more employees in the US, UK, India and China", "also": [ { "url": "https://www.gartner.com/en/newsroom/press-releases/2023-05-10-gartner-survey-reveals-47-percent-of-digital-workers-struggle-to-find-the-information-needed-to-effectively-perform-their-jobs", "quote": "uses is 11, compared to six applications in 2019" } ] }, "hbma": { "id": "hbma", "value": "Nearly 300", "claim": "HBMA, the billing companies' association, represents more than 47,000 employees at nearly 300 revenue cycle firms and billing departments.", "source_name": "HBMA, About HBMA", "url": "https://www.hbma.org/content/about/about-hbma", "quote": "The HBMA membership represents more than 47,000 employees at nearly 300 revenue cycle management firms and professional billing departments", "year": "Page as of October 2026", "population": "HBMA members" }, "hfma_vendor": { "id": "hfma_vendor", "value": "Nearly 80%", "claim": "Nearly 80% of health systems say an existing vendor would have the advantage over a new one for an AI pilot.", "source_name": "HFMA, Health system adoption of AI outpaces internal governance and strategy", "url": "https://www.hfma.org/press-releases/health-system-adoption-of-ai-outpaces-internal-governance-and-strategy/", "quote": "nearly 80% of health systems say an existing vendor or firm", "year": "August 2025 (Q2 2025 survey)", "population": "233 health systems" }, "hipaa_baa": { "id": "hipaa_baa", "value": "Written contract", "claim": "A covered entity may let an outside firm handle patient information on its behalf only with written assurances from that business associate, documented in a contract or other written agreement.", "source_name": "45 CFR 164.502(e) (eCFR)", "url": "https://www.ecfr.gov/current/title-45/section-164.502", "quote": "must be documented through a written contract or other written agreement or arrangement with the business associate that meets the applicable requirements of § 164.504(e)", "year": "Current rule", "population": "HIPAA covered entities" }, "hipaa_dates": { "id": "hipaa_dates", "value": "Dates", "claim": "Under HIPAA's Safe Harbor de-identification method, every element of a date except the year that relates to an individual, such as an admission or discharge date, is an identifier that must be removed.", "source_name": "45 CFR 164.514(b)(2)(i)(C) (eCFR, as of October 7, 2026)", "url": "https://www.ecfr.gov/current/title-45/section-164.514", "quote": "All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death", "year": "Current rule", "population": "HIPAA covered entities and business associates" }, "hrsa_cm": { "id": "hrsa_cm", "value": "Compliance Manual", "claim": "HRSA's Health Center Program Compliance Manual is its main guide to the Health Center Program requirements.", "source_name": "HRSA, Health Center Program Compliance Manual", "url": "https://bphc.hrsa.gov/compliance/compliance-manual", "quote": "The Health Center Program Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements.", "year": "Page as of October 2026", "population": "HRSA-funded health centers" }, "hrsa_needs": { "id": "hrsa_needs", "value": "Every three years", "claim": "A health center must complete or update a needs assessment of its current or proposed patients at least once every three years.", "source_name": "HRSA, Health Center Program Compliance Manual, Chapter 3: Needs Assessment", "url": "https://bphc.hrsa.gov/compliance/compliance-manual/chapter3", "quote": "The health center completes or updates a needs assessment of the current or proposed population at least once every three years", "year": "Page as of October 2026", "population": "HRSA-funded health centers" }, "hrsa_osv_top5": { "id": "hrsa_osv_top5", "value": "3 of 5", "claim": "Three of the five elements most often found noncompliant on HRSA site visits are credentialing and privileging items: procedures for reviewing privileges, the records themselves, and records for contracted and referral providers.", "source_name": "Forvis Mazars, Navigating HRSA On-Site Visits (presentation to the Community Health Center Association of Mississippi)", "url": "https://chcams.org/wp-content/uploads/2024/09/Navigating-HRSA-On-Site-Visits-Strategies-for-Health-Center-Preparedness.pdf", "quote": "Top 5 Non-Compliant Elements Identified On-Site", "year": "Presented September 20, 2024; the slide doesn't state the period or the number of visits", "population": "HRSA operational site visits (as reported by an accounting firm)", "also": [ { "url": "https://chcams.org/wp-content/uploads/2024/09/Navigating-HRSA-On-Site-Visits-Strategies-for-Health-Center-Preparedness.pdf", "quote": "Clinical Staffing: d. Procedures for Review of Privileges" }, { "url": "https://chcams.org/wp-content/uploads/2024/09/Navigating-HRSA-On-Site-Visits-Strategies-for-Health-Center-Preparedness.pdf", "quote": "Clinical Staffing: e. Credentialing & Privileging Records" }, { "url": "https://chcams.org/wp-content/uploads/2024/09/Navigating-HRSA-On-Site-Visits-Strategies-for-Health-Center-Preparedness.pdf", "quote": "Clinical Staffing: f. Credentialing & Privileging of Contracted or Referral Providers" } ] }, "hrsa_sac": { "id": "hrsa_sac", "value": "One-year award", "claim": "A health center with unresolved compliance conditions gets a one-year award instead of a four-year one, and two consecutive one-year awards while still noncompliant end its Health Center Program funding.", "source_name": "HRSA, FY 2026 Service Area Competition notice of funding opportunity (HRSA-26-004)", "url": "https://apply07.grants.gov/grantsws/rest/opportunity/att/download/348922", "quote": "We will NOT issue an FY 2026 SAC award if you had two consecutive one-year periods of performance in FY 2024 and FY 2025", "year": "FY 2026", "population": "Service Area Competition applicants", "also": [ { "url": "https://apply07.grants.gov/grantsws/rest/opportunity/att/download/348922", "quote": "you will receive a one-year period of performance, or HRSA may terminate your award" } ] }, "hrsa_svp": { "id": "hrsa_svp", "value": "Site Visit Protocol", "claim": "HRSA's Site Visit Protocol lists what its reviewers look for on a health center's operational site visit and the documents the center provides, such as board agendas and minutes, a list of its contracts, and the credentialing and privileging files of its clinical staff.", "source_name": "HRSA, Health Center Program Site Visit Protocol", "url": "https://bphc.hrsa.gov/compliance/site-visits/site-visit-protocol", "quote": "The Site Visit Protocol (SVP) is a guide for the operational site visits (OSVs) we conduct at health centers. It includes what we look for and how we assess compliance.", "year": "Page as of October 2026", "population": "HRSA-funded health centers", "also": [ { "url": "https://bphc.hrsa.gov/compliance/site-visits/site-visit-protocol/board-authority", "name": "board authority chapter", "quote": "Board agendas and minutes for:" }, { "url": "https://bphc.hrsa.gov/compliance/site-visits/site-visit-protocol/contracts-subawards", "name": "contracts chapter", "quote": "health center contracts that support the Health Center Program project" }, { "url": "https://bphc.hrsa.gov/compliance/site-visits/site-visit-protocol/clinical-staffing", "name": "clinical staffing chapter", "quote": "Files for current clinical staff that contain credentialing and privileging information" } ] }, "hrsa_target": { "id": "hrsa_target", "value": "1.25% to 5%", "claim": "A health center that projects fewer than 95% of the patients HRSA targets for its service area has its grant request cut by 1.25% to 5%, and below 75% of that target it is not eligible for funding.", "source_name": "HRSA, FY 2026 Service Area Competition notice of funding opportunity (HRSA-26-004), Table 1", "url": "https://apply07.grants.gov/grantsws/rest/opportunity/att/download/348922", "quote": "At least 90% but less than 95% of patients listed in the SAAT 1.25%", "year": "FY 2026", "population": "Service Area Competition applicants" }, "irs_chna": { "id": "irs_chna", "value": "Five steps", "claim": "The tax rules set five steps for a hospital facility's CHNA: define the community it serves, assess that community's health needs, take input from at least one public health department and from people who represent the community, document it in a report adopted by an authorized body of the facility, and make the report widely available to the public.", "source_name": "26 CFR 1.501(r)-3 and 1.501(r)-1 (eCFR, as of October 7, 2026)", "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-3", "quote": "must solicit and take into account input received from all of the following sources", "year": "October 7, 2026", "population": "501(c)(3) hospital facilities", "also": [ { "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-3", "quote": "At least one state, local, tribal, or regional governmental public health department" }, { "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-3", "quote": "adopted for the hospital facility by an authorized body of the hospital facility" }, { "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-3", "quote": "Make the CHNA report widely available to the public" }, { "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-3", "quote": "a hospital facility must complete all of the following steps" }, { "url": "https://www.ecfr.gov/current/title-26/section-1.501(r)-1", "in_name": "1.501(r)-1", "quote": "The governing body (that is, the board of directors, board of trustees, or equivalent controlling body) of the hospital organization that operates the hospital facility or a committee of, or other party authorized by, that governing body" } ] }, "irs_chna_3yr": { "id": "irs_chna_3yr", "value": "Every 3 years", "claim": "A hospital organization must conduct a community health needs assessment every three years.", "source_name": "IRS, Community health needs assessment for charitable hospital organizations, Section 501(r)(3)", "url": "https://www.irs.gov/charities-non-profits/community-health-needs-assessment-for-charitable-hospital-organizations-section-501r3", "quote": "Section 501(r)(3)(A) requires a hospital organization to conduct a community health needs assessment (CHNA) every three years", "year": "Current law", "population": "501(c)(3) hospital organizations" }, "jc_chai_ai": { "id": "jc_chai_ai", "value": "September 2025", "claim": "The Joint Commission and the Coalition for Health AI released guidance on the responsible use of AI in health care on September 17, 2025, with recommendations on AI policies, local validation and monitoring.", "source_name": "AHA News, Joint Commission unveils first AI guidance in partnership with Coalition for Health AI", "url": "https://www.aha.org/news/headline/2025-09-18-joint-commission-unveils-first-ai-guidance-partnership-coalition-health-ai", "quote": "The guidance includes recommendations on AI policies, local validation, monitoring and use for interpretation and integration into new or existing processes.", "year": "September 18, 2025", "population": "Health care organizations" }, "kff_chc_count": { "id": "kff_chc_count", "value": "1,356", "claim": "1,356 HRSA-funded health center organizations served more than 32.7 million patients at over 16,600 sites in 2025.", "source_name": "KFF, Community Health Center Patients, Financing, and Services", "url": "https://www.kff.org/medicaid/community-health-center-patients-financing-and-services/", "quote": "In 2025, 1,356 health center organizations provided care at over 16,600 service delivery sites", "year": "Published October 5, 2026, with 2025 data", "population": "HRSA-funded health centers", "also": [ { "url": "https://www.kff.org/medicaid/community-health-center-patients-financing-and-services/", "quote": "served more than 32.7 million patients in 2025" } ] }, "kff_chc_grants": { "id": "kff_chc_grants", "value": "14%", "claim": "Grants and contracts other than the core federal grant make up 14% of health center revenue.", "source_name": "KFF, Community Health Center Patients, Financing, and Services", "url": "https://www.kff.org/medicaid/community-health-center-patients-financing-and-services/", "quote": "made up 10% of total revenue while other grants and contracts accounted for 14%", "year": "Published October 5, 2026, with 2025 data", "population": "HRSA-funded health centers" }, "kff_chc_lang": { "id": "kff_chc_lang", "value": "27%", "claim": "27% of health center patients (8.8 million people) are best served in a language other than English.", "source_name": "KFF, Community Health Center Patients, Financing, and Services", "url": "https://www.kff.org/medicaid/community-health-center-patients-financing-and-services/", "quote": "nearly three in ten patients (27% or 8.8 million) were best served in a language other than English", "year": "Published October 5, 2026, with 2025 data", "population": "HRSA-funded health center patients" }, "kff_rht": { "id": "kff_rht", "value": "$10 billion a year", "claim": "A new federal rural health fund sends states $10 billion a year from 2026 to 2030, and its permitted uses include AI for clinical and administrative work.", "source_name": "KFF, A Closer Look at the $50 Billion Rural Health Transformation Program", "url": "https://www.kff.org/medicaid/a-closer-look-at-the-50-billion-rural-health-transformation-program/", "quote": "CMS will award $10 billion in grants to approved states each year from fiscal years 2026 to 2030", "year": "Updated September 2026", "population": "States", "also": [ { "quote": "promoting artificial intelligence for clinical and administrative uses" } ] }, "ku_trials": { "id": "ku_trials", "value": "171 business days", "claim": "At one NCI cancer center, the median study took 171 business days to activate; NCI's working group sets an aspirational 90-day target for the whole start-up process.", "source_name": "University of Kansas Cancer Center study, Contemporary Clinical Trials Communications, 2025", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12595353/", "quote": "The median number of Activation Days is 171", "year": "2025", "population": "315 studies at one NCI cancer center" }, "medpac_counts": { "id": "medpac_counts", "value": "14,400", "claim": "In 2024, about 14,400 freestanding skilled nursing facilities and 6,706 hospices served Medicare patients, and more than 12,000 home health agencies were certified to take part in Medicare.", "source_name": "MedPAC, March 2026 Report to the Congress, Chapter 7", "url": "https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch7_MedPAC_Report_To_Congress_SEC.pdf", "quote": "In 2024, about 14,400 freestanding SNFs furnished about 1.5 million Medicare-covered stays", "year": "2024", "population": "Medicare providers", "also": [ { "url": "https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch8_MedPAC_Report_To_Congress_SEC.pdf", "name": "Chapter 8", "quote": "In that year, there were over 12,000 HHAs certified to participate in Medicare" }, { "url": "https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf", "name": "Chapter 10", "quote": "In 2024, 6,706 hospices provided care to Medicare beneficiaries" } ] }, "medpac_hospice_cap": { "id": "medpac_hospice_cap", "value": "28%", "claim": "About 28% of hospices exceeded Medicare's aggregate cap in 2023, by about $410,000 on average.", "source_name": "MedPAC, March 2026 Report to the Congress, Chapter 10", "url": "https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch10_MedPAC_Report_To_Congress_SEC.pdf", "quote": "each above-cap hospice exceeded the cap by about $410,000 in 2023", "year": "2023 data", "population": "Medicare hospices", "also": [ { "quote": "about 28 percent of hospices" } ] }, "medpac_snf_turnover": { "id": "medpac_snf_turnover", "value": "46%", "claim": "In the median skilled nursing facility, 46% of nursing staff turned over in the 12 months to 2024.", "source_name": "MedPAC, March 2026 Report to the Congress, Chapter 7", "url": "https://www.medpac.gov/wp-content/uploads/2026/03/Mar26_Ch7_MedPAC_Report_To_Congress_SEC.pdf", "quote": "The 12-month rate of nursing staff turnover as of 2024 was 46 percent for the median SNF", "year": "2024 data", "population": "Medicare skilled nursing facilities" }, "mgi_renewal": { "id": "mgi_renewal", "value": "82%", "claim": "In MGI's 2026 benchmarking report, the median association membership renewal rate was 82%, and 38% of associations reported membership growth, down from 45% in the previous year's report.", "source_name": "Marketing General Inc., 2026 Membership Marketing Benchmarking Report, as summarized on Tony Rossell's Membership Marketing Blog", "url": "https://membershipmarketing.blogspot.com/2026/07/just-released-2026-membership-marketing.html", "quote": "the median renewal rate from the 2026 report remained at 82 percent", "year": "2026", "population": "Associations responding to MGI's 2026 benchmarking survey", "also": [ { "quote": "The report also notes a softening in the share of associations reporting membership increases, down from 45 percent to 38 percent." } ] }, "mgma_denials": { "id": "mgma_denials", "value": "60%", "claim": "60% of medical group leaders said their claim denial rates rose in early 2024.", "source_name": "MGMA Stat, Strategic improvements in your RCM to reduce claim denials", "url": "https://www.mgma.com/mgma-stat/strategic-improvements-in-your-rcm-to-reduce-your-practices-claim-denials", "quote": "60% of medical group leaders reported an increase in their practices' claim denial rates", "year": "Poll March 5, 2024", "population": "235 medical group leaders" }, "mgma_ma_hiring": { "id": "mgma_ma_hiring", "value": "56%", "claim": "56% of medical practices said hiring medical assistants got harder in the past year.", "source_name": "MGMA Stat, Medical assistants: tackling practices' worst hiring problem", "url": "https://www.mgma.com/mgma-stat/medical-assistants-tackling-practices-worst-hiring-problem", "quote": "56% of medical practices report MA hiring has gotten more difficult in the past year", "year": "Poll May 19, 2026", "population": "297 medical practice leaders" }, "nachc_cash": { "id": "nachc_cash", "value": "Nearly half", "claim": "Nearly half of community health centers operate with fewer than 90 days of cash on hand.", "source_name": "NACHC, Community Health Center Policy Priorities (September 2026)", "url": "https://www.nachc.org/wp-content/uploads/2026/09/Policy-Papers_CHCPriorities_Sept-2026_FINAL.pdf", "quote": "Nearly half of CHCs operate with fewer than 90 days of cash on hand", "year": "citing a February 2026 NACHC analysis", "population": "Community health centers" }, "nachc_ma": { "id": "nachc_ma", "value": "24%", "claim": "Of the health center jobs in NACHC's 2025 staffing survey, medical assistants had the highest turnover, at 24% a year.", "source_name": "NACHC, Investing in the Primary Care Front Line (2025 staffing survey)", "url": "https://www.nachc.org/investing-in-the-primary-care-front-line-why-chcs-need-workforce-investment-now/", "quote": "Medical assistants experienced the highest turnover rate at 24%", "year": "2025", "population": "Community health centers, national estimates" }, "nachc_unwind": { "id": "nachc_unwind", "value": "$595,000", "claim": "Health centers surveyed in January 2024 had lost an average of $595,000 each in the Medicaid unwinding, when states rechecked every enrollee's eligibility after a pandemic-era rule that kept people enrolled ended, and their staff had spent an average of 1,600 hours helping patients.", "source_name": "NACHC and GWU Geiger Gibson Program, The Impact of Medicaid Unwinding on Community Health Center Patients, Revenue, and Resources", "url": "https://www.nachc.org/wp-content/uploads/2024/04/NACHC_Impact-of-Medicaid-Unwinding.pdf", "quote": "Health Centers lost an average of $595,000 due to redetermination", "year": "Survey January 2024", "population": "222 responding health centers (17% response rate)", "also": [ { "url": "https://www.kff.org/medicaid/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision/", "name": "KFF on the unwinding", "quote": "Congress delinked the continuous enrollment provision from the PHE, ending continuous enrollment on March 31, 2023." } ] }, "nih_ai": { "id": "nih_ai", "value": "July 2025", "claim": "NIH won't consider applications substantially developed by AI to be the applicants' original ideas.", "source_name": "NIH notice NOT-OD-25-132, Supporting Fairness and Originality in NIH Research Applications", "url": "https://grants.nih.gov/grants/guide/notice-files/NOT-OD-25-132.html", "quote": "NIH will not consider applications that are either substantially developed by AI, or contain sections substantially developed by AI, to be original ideas of applicants", "year": "Released July 17, 2025", "population": "NIH research applications" }, "nsi_travel": { "id": "nsi_travel", "value": "$66,081", "claim": "A travel nurse costs the average hospital $66,081 a year more than a staff RN.", "source_name": "NSI Nursing Solutions, 2026 National Health Care Retention and RN Staffing Report", "url": "https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf", "quote": "$31.77 / $66,081", "year": "Calendar 2025 data", "population": "527 hospitals in 40 states (NSI is a recruitment firm)" }, "nyc_aedt": { "id": "nyc_aedt", "value": "Bias audit", "claim": "New York City bars employers from using an automated employment decision tool unless it has had a bias audit within the past year; enforcement began July 5, 2023.", "source_name": "NYC Department of Consumer and Worker Protection, Automated Employment Decision Tools", "url": "https://www.nyc.gov/site/dca/about/automated-employment-decision-tools.page", "quote": "unless the tool has been subject to a bias audit within one year of the use of the tool", "year": "Local Law 144 of 2021; enforced from July 5, 2023", "population": "Employers and employment agencies hiring in NYC", "also": [ { "url": "https://www.nyc.gov/site/dca/about/automated-employment-decision-tools.page", "quote": "DCWP will begin enforcement of this law and rule on July 5, 2023" } ] }, "ocr_cadia": { "id": "ocr_cadia", "value": "$182,000", "claim": "Five Delaware skilled nursing and rehabilitation facilities paid $182,000 after a website “success story” disclosed a patient's name, photo and treatment.", "source_name": "HHS Office for Civil Rights, Cadia Healthcare Facilities settlement", "url": "https://www.hhs.gov/press-room/ocr-settles-hipaa-with-cadia-healthcare-facilities.html", "quote": "paid $182,000 to OCR", "year": "2025", "population": "Five facilities" }, "ocr_reviews": { "id": "ocr_reviews", "value": "$23,000 and $30,000", "claim": "A dental practice paid $23,000 and a psychiatric practice paid $30,000 to settle HIPAA cases over replies to online reviews that disclosed patient information.", "source_name": "HHS Office for Civil Rights resolution agreements: New Vision Dental and Manasa Health Center", "url": "https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/new-vision/index.html", "quote": "New Vision Dental paid $23,000 to OCR", "year": "2022 and 2023", "population": "Two practices", "also": [ { "url": "https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/manasa/index.html", "name": "Manasa Health Center agreement", "in_name": "Manasa Health Center", "quote": "Manasa Health Center paid $30,000 to OCR" } ] }, "pew_ai_summary": { "id": "pew_ai_summary", "value": "8% vs. 15%", "claim": "Google users clicked a regular search result on 8% of visits that showed an AI summary, against 15% of visits without one.", "source_name": "Pew Research Center, Google users are less likely to click on links when an AI summary appears", "url": "https://www.pewresearch.org/short-reads/2025/07/22/google-users-are-less-likely-to-click-on-links-when-an-ai-summary-appears-in-the-results/", "quote": "Users who encountered an AI summary clicked on a traditional search result link in 8% of all visits.", "year": "March 2025 data, published July 2025", "population": "900 US adults, 68,879 searches" }, "phti": { "id": "phti", "value": "38%", "claim": "68% of employers and 55% of health plans use performance-based contracts for digital health, and 38% of purchasers with those contracts say they cannot independently verify the outcomes vendors report.", "source_name": "Peterson Health Technology Institute, 2026 State of Digital Health Purchasing", "url": "https://www.phti.org/announcement/phti-survey-finds-majority-of-employers-and-health-plans-are-using-performance-based-contracting-to-pay-for-digital-health-tools/", "quote": "38% say they cannot independently verify the outcomes that vendors report", "year": "Survey July 2026, published September 2026", "population": "321 purchasing decision makers at employers, health plans and health systems; the 38% is among the 182 with performance-based contracts", "also": [ { "quote": "68% of employers and 55% of health plans, indicate they are currently using performance-based contracts" }, { "url": "https://www.phti.org/wp-content/uploads/2026/09/PHTI-2026-State-of-Digital-Health-Purchasing.pdf", "name": "PHTI's report, page 22", "quote": "What challenges, if any, has your organization experienced with vendor-provided data in the context of performance-based contracts? Select all that apply. (n=182)" }, { "url": "https://www.phti.org/research-insight/2026-state-of-digital-health-purchasing/", "name": "PHTI's report page", "quote": "The survey was fielded between July 1 and July 22, 2026." } ] }, "premier": { "id": "premier", "value": "$57.23", "claim": "Fighting a denied claim cost hospitals $57.23 per claim in 2023; nearly 15% of claims are denied at first, and about 70% of denials are eventually paid.", "source_name": "Premier, Claims Adjudication Costs Providers $25.7 Billion", "url": "https://premierinc.com/newsroom/policy/claims-adjudication-costs-providers-257-billion-18-billion-is-potentially-unnecessary-expense", "quote": "from $43.84 per claim in 2022 to $57.23 in 2023", "year": "2023 data, published February 2025", "population": "280 hospitals in 23 states", "also": [ { "quote": "approximately 70 percent of denials are overturned and paid" } ] }, "senate_ghost": { "id": "senate_ghost", "value": "More than 80%", "claim": "In a Senate secret-shopper study of Medicare Advantage directories, more than 80% of listed mental health providers were unreachable, not in network or not taking new patients.", "source_name": "US Senate Committee on Finance, Medicare Advantage Plan Directories Haunted by Ghost Networks", "url": "https://www.finance.senate.gov/imo/media/doc/050323%20Ghost%20Network%20Hearing%20-%20Secret%20Shopper%20Study%20Report.pdf", "quote": "More than 80% of the listed, in-network, mental health providers staff attempted to contact were therefore", "year": "May 2023", "population": "120 calls to 12 Medicare Advantage plans in 6 states" }, "senate_psi": { "id": "senate_psi", "value": "22.7%", "claim": "UnitedHealthcare's prior authorization denial rate for post-acute care rose from 10.9% in 2020 to 22.7% in 2022.", "source_name": "US Senate Permanent Subcommittee on Investigations, Majority Staff Report on Medicare Advantage", "url": "https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf", "quote": "22.7 percent in 2022", "year": "October 2024 (2020 to 2022 data)", "population": "Three largest Medicare Advantage insurers" }, "shvs_rht": { "id": "shvs_rht", "value": "$25 million", "claim": "In spring 2026, states opened their first rounds for hospitals and other rural organizations to apply for rural health fund money. Pennsylvania offered $25 million with awards up to $1 million, and Arkansas opened applications for $209 million.", "source_name": "State Health and Value Strategies, May 2026: State Implementation of the Rural Health Transformation Program Ramps Up", "url": "https://shvs.org/states-of-innovation-resources/may-2026-state-implementation-of-the-rural-health-transformation-program-ramps-up/", "quote": "making $25 million available to qualified entities including hospitals", "year": "May 2026", "population": "Selected states", "also": [ { "url": "https://shvs.org/states-of-innovation-resources/may-2026-state-implementation-of-the-rural-health-transformation-program-ramps-up/", "quote": "funded projects will receive up to $1 million" }, { "url": "https://shvs.org/states-of-innovation-resources/may-2026-state-implementation-of-the-rural-health-transformation-program-ramps-up/", "quote": "the initial application process is underway for $209 million in funding" } ] }, "tax4959": { "id": "tax4959", "value": "$50,000", "claim": "A nonprofit hospital organization owes a $50,000 excise tax for each of its hospitals that misses its community health needs assessment, and owes it again for each year that hospital stays out of compliance.", "source_name": "26 U.S.C. 4959 and 26 CFR 53.4959-1", "url": "https://www.ecfr.gov/current/title-26/section-53.4959-1", "quote": "the $50,000 tax is imposed on the hospital organization separately for each hospital facility's failure", "year": "Statute since 2010", "population": "501(c)(3) hospital organizations", "also": [ { "url": "https://www.law.cornell.edu/uscode/text/26/4959", "name": "statute text", "in_name": "26 U.S.C. 4959", "quote": "there is imposed on the organization a tax equal to $50,000. (Added Pub. L. 111-148, title IX, § 9007(b)(1), Mar. 23, 2010, 124 Stat. 857.)" } ] }, "uds_due": { "id": "uds_due", "value": "February 15", "claim": "UDS reports for 2026 are due February 15, 2027.", "source_name": "HRSA, 2026 Uniform Data System Manual", "url": "https://bphc.hrsa.gov/sites/default/files/bphc/compliance/2026-uds-manual.pdf", "quote": "UDS Reports are to be submitted by February 15, 2027.", "year": "2026 reporting year", "population": "HRSA-funded health centers" }, "w3c_tools": { "id": "w3c_tools", "value": "Human judgment", "claim": "Accessibility testing tools cannot check every part of accessibility automatically; human judgment is required.", "source_name": "W3C Web Accessibility Initiative, Selecting Web Accessibility Evaluation Tools", "url": "https://www.w3.org/WAI/test-evaluate/tools/selecting/", "quote": "Tools cannot check all accessibility aspects automatically. Human judgement is required.", "year": "Page as of October 2026", "population": "Web accessibility testing" }, "kff_ai32": { "id": "kff_ai32", "value": "32%", "claim": "About a third of US adults (32%) turn to AI tools for health information and advice.", "source_name": "KFF Tracking Poll on Health Information and Trust: Use of AI for Health Information and Advice", "url": "https://www.kff.org/public-opinion/kff-tracking-poll-on-health-information-and-trust-use-of-ai-for-health-information-and-advice/", "quote": "about a third (32%) of adults are turning to AI for health information and advice", "year": "2026 (survey conducted February 24 to March 2)", "population": "1,343 US adults" } }, "quiz": { "note": "Rule-based and transparent: every recommendation lists the answers that produced it. No patient data is asked.", "questions": [ { "id": "segment", "q": "What kind of organization are you?", "options": [ "health-systems", "community-hospitals", "health-centers", "practices", "post-acute", "health-tech" ] }, { "id": "size", "q": "Which describes it best?", "options_by_segment": { "health-systems": [ "Academic medical center", "System of 6 or more hospitals", "Smaller system" ], "community-hospitals": [ "Critical access or under 50 beds", "50 to 200 beds", "Over 200 beds" ], "health-centers": [ "Under 10,000 patients", "10,000 to 25,000", "Over 25,000", "Health department", "Free or charitable clinic" ], "practices": [ "Fewer than 5 staff", "5 or more staff, 1 to 4 clinicians", "5 to 20 clinicians", "More than 20 clinicians, or a DSO, IPA or MSO" ], "post-acute": [ "Nursing home", "Home health or hospice agency", "Senior living or PACE", "Several sites or agencies" ], "health-tech": [ "Digital health company", "Revenue cycle firm", "Staffing firm", "Association or society" ] } }, { "id": "role", "q": "What is your role?", "options": [ "CEO, owner or administrator", "Finance or revenue", "Operations or clinical manager", "Compliance or quality", "HR", "Marketing, sales or growth", "IT or data" ] }, { "id": "area", "q": "Where are your biggest problems?", "options": [ "financial", "administrative", "workforce", "compliance", "growth", "operational" ] }, { "id": "data", "q": "Where do your files live today?", "options": [ "Microsoft 365", "Google Workspace", "Our own cloud or data warehouse", "Mostly spreadsheets and shared drives", "Not sure" ] }, { "id": "baa", "q": "Could you start with work that needs no patient data?", "options": [ "Yes, start without patient data", "We need patient-level work" ] }, { "id": "timeline", "q": "When do you want something running?", "options": [ "This quarter", "Within six months", "Just exploring" ], "follow_up": { "show_for_segments": [ "community-hospitals", "health-systems", "health-centers" ], "id": "chna_due", "q": "When is your next community health needs assessment due?", "options": [ "Within 12 months", "In 1 to 2 years", "More than 2 years away", "We don't do one", "Not sure" ] } } ], "scoring": [ "Only tools with status 'launch' that list the chosen segment can be recommended; held and after-BAA tools appear under 'Also ask about'", "+3 for each problem in the chosen segment and area that the tool addresses", "+1 if the chosen role appears in that problem's 'who'", "+3 to the Funding and Needs Assessment Desk if the CHNA is due within 12 months", "+3 to Nursing Home Survey Readiness if the size answer is 'Nursing home'; +3 to the Weekly Leadership Brief if it is 'Home health or hospice agency', and the brief then shows the price of its operator version", "Practices with fewer than 5 staff, or 1 to 4 clinicians, that pick 'Money and payers', 'Rules, surveys and audits' or 'Patients, referrals and customers' see the practice starter first: the $1,500 website and reviews check plus the owner's brief, $11,000 in year one", "Health centers and the smallest size options see the entry price and the year-one cost first", "If the answer is 'We need patient-level work', say plainly that it isn't available yet, invite a written proposal to ask about it, and recommend the closest tool that needs no patient data. Never show a price for patient-level work", "Problems that belong to one sub-type (listed in 'sizes') show only when the size answer is that sub-type", "The 'Where do your files live' answer is shown on the result as where the tool would run. It changes the score only for Spreadsheet to App: +2 if the answer is 'Mostly spreadsheets and shared drives' and the area is 'Reports, data and spreadsheets', 'Paperwork and back office' or 'Daily operations'", "'Just exploring' adds the AI Leadership Workshop as an alternate", "The recommendation is the highest-scoring service built for a problem in the chosen area; when none is, a written proposal leads. The next two by score are alternates, and an alternate can outscore the recommendation when its points come from answers that apply to any area, such as a needs assessment due within 12 months. 'Just exploring', choosing an AI product, and a TEAM hospital with a money and payers problem each keep their named service among the alternates. Ties go to the lower 'from' price on the menu, and the result says so" ], "role_to_area": { "CEO, owner or administrator": [ "financial", "growth" ], "Finance or revenue": [ "financial" ], "Operations or clinical manager": [ "operational", "workforce" ], "Compliance or quality": [ "compliance" ], "HR": [ "workforce" ], "Marketing, sales or growth": [ "growth" ], "IT or data": [ "administrative", "operational" ] }, "book_prefill": "leaning toward: , , ; note: , , , files in , CHNA due ", "patient_level_prefill": "note: wants patient-level work when it opens; , , " } }