After cardiac surgery, patients are at risk for both high and low blood sugar, which can lead to serious complications. Managing these fluctuations requires careful insulin dosing, but existing protocols often fall short due to the unpredictable nature of ICU care and differences among patients, say the investigators. 

To address this challenge, the research team created a reinforcement learning model, named GLUCOSE, that recommends insulin doses tailored to each patient’s needs. In tests using data from real-world ICU cases, GLUCOSE matched or even outperformed experienced clinicians in keeping blood sugar levels within a safe range—despite having access to only current patient data, while doctors used full patient histories. 

“Our study shows that artificial intelligence can be thoughtfully and responsibly developed to support, rather than replace, the clinical judgment of health care professionals,” says co-senior corresponding author Ankit Sakhuja, MBBS, MS, Associate Professor of Medicine (Data-Driven and Digital Medicine) and a member of the Institute for Critical Care Medicine at the Icahn School of Medicine at Mount Sinai. “In complex and high-pressure environments like the ICU, tools like GLUCOSE can provide real-time data-driven guidance tailored to individual patients. This kind of decision support can enhance safety, reduce the risk of complications, and ultimately allow clinicians to focus more of their attention on critical aspects of patient care.” 

The research team trained GLUCOSE using reinforcement learning, which allowed the system to learn optimal decisions through trial and error. They also used advanced methods—conservative and distributional reinforcement learning—to ensure the model made cautious, reliable recommendations. The model was then rigorously evaluated and compared to real-world clinical practices. 

While the results are promising, the researchers caution that GLUCOSE is not intended to replace doctors. It serves as a clinical decision support tool, offering suggestions that physicians can choose to follow based on their judgment and the broader clinical picture. 

The model could eventually be integrated into electronic health record systems to provide real-time insulin dosing guidance in the ICU, helping reduce complications and improve outcomes. Future steps include adapting the tool for use in other hospital settings, running clinical trials, and exploring ways to integrate it into routine care. 

One current limitation is that the model does not yet factor in nutrition data, which may affect longer-term glucose control. Still, the ability of GLUCOSE to make accurate recommendations based on limited real-time data highlights its potential to enhance safety and efficiency in postsurgical care. 

“Our goal is to develop AI systems that meaningfully augment the capabilities of health care providers and ultimately improve patient outcomes,” says co-senior corresponding author Girish N. Nadkarni, MD, MPH, Chair of the Windreich Department of Artificial Intelligence and Human Health, Director of the Hasso Plattner Institute for Digital Health, and Irene and Dr. Arthur M. Fishberg Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and Chief AI Officer of the Mount Sinai Health System. “By learning from real-world clinical data and delivering personalized recommendations in real time, models like GLUCOSE represent an important advance toward integrating trustworthy data-driven tools into the clinical workflow. This study offers a glimpse of how AI can be thoughtfully embedded into care to support providers in delivering safer, more precise treatment.” 

The paper is titled “A Distributional Reinforcement Learning Model for Optimal Glucose Control After Cardiac Surgery.” 

The study’s authors, as listed in the journal, are Jacob M. Desman, Zhang-Wei Hong, Moein Sabounchi, Ashwin S. Sawant, Jaskirat Gill, Ana C. Costa, Gagan Kumar, Rajeev Sharma, Arpeta Gupta, Paul McCarthy, Veena Nandwani, Doug Powell, Alexandra Carideo, Donnie Goodwin, Sanam Ahmed, Umesh Gidwani, Matthew A. Levin, Robin Varghese, Farzan Filsoufi, Robert Freeman, Avniel Shetreat-Klein, Alexander W. Charney, Ira Hofer, Lili Chan, David Reich, Patricia Kovatch, Roopa Kohli-Seth, Monica Kraft, Pulkit Agrawal, John A. Kellum, Girish N. Nadkarni, and Ankit Sakhuja. 

The study was funded, in part, by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health grant 5K08DK131286, and by the Clinical and Translational Science Awards (CTSA) grant UL1TR004419 from the National Center for Advancing Translational Sciences. Research reported in this publication was also supported by the Office of Research Infrastructure of the National Institutes of Health under award numbers S10OD026880 and S10OD030463.  

See the journal paper for conflicts of interest: https://www.nature.com/articles/s41746-025-01709-9. 

About Mount Sinai’s Windreich Department of AI and Human Health   

Led by Girish N. Nadkarni, MD, MPH—an international authority on the safe, effective, and ethical use of AI in health care—Mount Sinai’s Windreich Department of AI and Human Health is the first of its kind at a U.S. medical school, pioneering transformative advancements at the intersection of artificial intelligence and human health.  

The Department is committed to leveraging AI in a responsible, effective, ethical, and safe manner to transform research, clinical care, education, and operations. By bringing together world-class AI expertise, cutting-edge infrastructure, and unparalleled computational power, the department is advancing breakthroughs in multi-scale, multimodal data integration while streamlining pathways for rapid testing and translation into practice.  

The Department benefits from dynamic collaborations across Mount Sinai, including with the Hasso Plattner Institute for Digital Health at Mount Sinai—a partnership between the Hasso Plattner Institute for Digital Engineering in Potsdam, Germany, and the Mount Sinai Health System—which complements its mission by advancing data-driven approaches to improve patient care and health outcomes.  

At the heart of this innovation is the renowned Icahn School of Medicine at Mount Sinai, which serves as a central hub for learning and collaboration. This unique integration enables dynamic partnerships across institutes, academic departments, hospitals, and outpatient centers, driving progress in disease prevention, improving treatments for complex illnesses, and elevating quality of life on a global scale.  

In 2024, the Department’s innovative NutriScan AI application, developed by the Mount Sinai Health System Clinical Data Science team in partnership with Department faculty, earned Mount Sinai Health System the prestigious Hearst Health Prize. NutriScan is designed to facilitate faster identification and treatment of malnutrition in hospitalized patients. This machine learning tool improves malnutrition diagnosis rates and resource utilization, demonstrating the impactful application of AI in health care.  

For more information on Mount Sinai’s Windreich Department of AI and Human Health, visit: ai.mssm.edu  

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CCI’s approach is designed to support rapid advancement of ambitious research in complex scientific and medical fields. Focusing initially on neuroscience and systems biology, and the convergence of these multidisciplinary areas facilitated through innovative technologies, CCI will help further ambitious projects that improve health and well-being for all. Examples include the development of a novel therapeutic approach leveraging neuro-inspired AI systems, and CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) to engineer entire ecosystems. 

“Despite major advances in recent decades, global health and access to quality care has not sufficiently improved and in some cases is actually declining. Solving these challenges requires scientific rigor and exploration of complex, interconnected systems that underpin human health. The classic reductionist approach to R&D viewed these as distinct scientific disciplines to be studied in isolation,” said Caleb B. Bell III, PhD, President and Executive Director of CCI. “We are empowering scientists and innovators to take a new approach to today’s biggest challenges, supported by a global ecosystem of like-minded individuals. With a systems biology, non-reductionist mindset, groundbreaking insights can rapidly translate into viable solutions that improve global health and well-being.”

The CCI model represents a fundamental shift in how scientific research is funded, developed and translated globally. By identifying high-potential researchers early in their careers and providing them with dedicated, long-term resources, CCI enables scientists and innovators to explore ambitious projects without the constraints of short-term thinking. The CCI team has cultivated a collaborative, global network of thought leaders in science, business, and finance to help innovators overcome obstacles and accelerate progress.

“Corundum Convergence Institute is building a platform where groundbreaking science is not only supported but also stewarded with a clear pathway to societal benefit,” said Yasushi Yamamoto, CEO of Corundum Corp. “By integrating resources and leveraging expertise from across the Corundum network, we are positioning CCI to be a critical force in bridging cutting-edge research with real-world impact, laying the foundation for a new era in health innovation.”

Corundum Convergence Institute is an independently governed entity, created by fellow Corundum Corp venture builders and funds Corundum Neuroscience and Corundum Systems Biology, with the specific mission of funding early-stage scientific research in the fields of neuroscience, systems biology and artificial intelligence.

About Corundum Convergence Institute (CCI)

Corundum Convergence Institute (CCI) is a non-profit organization committed to advancing transformative research at the frontiers of neuroscience, systems biology, and artificial intelligence. By focusing on early-stage innovation in complex, high-impact fields, CCI supports the development of products and technologies leading to paradigm shifts in healthcare, including novel therapeutic approaches to neuro-inspired AI and improved diagnostics for neurodegenerative and metabolic conditions. CCI’s multidisciplinary approach fosters convergence across fields, enabling scientists and entrepreneurs to explore the intersections of science, human biology and advanced technology in ways that will fundamentally reshape health and wellbeing. As part of the greater Corundum network, CCI offers a creative path to translate bold scientific ideas to real-world impact.

For company updates and information, follow Corundum Convergence Institute on LinkedIn or visit https://cci-fund.org.

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The Marfan Foundation is the world’s most extensive patient and professional community addressing the needs of people living with genetic aortic and vascular conditions, serving one million people with educational materials and reaching 3.2 million people in the digital space annually.

The Marfan Foundation will play a crucial role in informing individuals living with Marfan, Loeys-Dietz, Vascular Ehlers-Danlos syndromes, and related conditions about the resources and community dialogue offered by StuffThatWorks. This collaboration will enable StuffThatWorks to develop a comprehensive strategy for engaging non-profits with the goal of ultimately benefiting the global patient community.

“We’re honored to have been selected as the first non-profit to align with StuffThatWorks to elevate community members’ voices, foster additional personal empowerment, and advance access to potential learnings that may be derived through global self-reporting,” said Michael L. Weamer, CEO of The Marfan Foundation.

StuffThatWorks’ operational value is that patients’ crowdsourcing information can highlight issues that need to be addressed from the patient perspective as well as spotlight various treatment options, side effects, and obstacles to care: “Understanding how patients experience various treatments is one of them,” according to their website. “The Marfan Foundation has a steadfast commitment to scientific rigor and fostering a strong global community. Operationally, the Foundation leverages world-class experts to focus on research and best practices in patient engagement and empowerment,” says Yael Elish, CEO of StuffThatWorks. “The Foundation’s investment in basic and applied research and translating these understandings into patient support and education reinforces that real-world data is valued in applications with the potential to advance treatments and quality of life.”

“We’re enthused to share what we know about specific non-profit needs and goals while we learn more about the possibilities StuffThatWorks’ patient-centric knowledge-base will offer,” said Weamer.

About 1 in 5000 people have Marfan syndrome, including men and women of all races and ethnic groups. Roughly 3 out of 4 people with Marfan syndrome inherit it. There is a 50 percent chance that a person with Marfan syndrome will pass along the condition each time they have a child. Because connective tissue is impacted and found throughout the body, Marfan syndrome can affect many body parts. Features of the condition are most often found in the heart, blood vessels, bones, joints, and eyes. Some Marfan features – for example, aortic enlargement (expansion of the main blood vessel that carries blood away from the heart to the rest of the body) – can be life-threatening. People living with Marfan syndrome and related conditions have a 250 times greater risk of aortic dissection than the general public. The lungs, skin, and nervous system may also be affected.

About StuffThatWorks

Created by Waze founding team members, StuffThatWorks uses crowdsourcing and AI to empower patients to transform their experiences into organized, large-scale structured Real-World Data needed for research. StuffThatWorks is the home to three million members across 1250 condition communities that have shared 1.3B data points. Now the largest organized Patient Level Real World Data platform, StuffThatWorks is differentiated by its expansive data collection, structuring, and organization of accessible information. The unique proprietary data set and unique AI and powerful Chat GPT-like capabilities enable the generation of insights for research, market access, and drug development.

Crowdsourcing Treatments that Work | Community Research | StuffThatWorks

About the Marfan Foundation

The Marfan Foundation is a global nonprofit organization that empowers people with genetic aortic and vascular conditions to foster optimal quality of life and longevity while building community. We save lives through research and education, enabling healthcare providers to offer the best-quality treatment and helping to foster mental and physical wellbeing. We serve communities impacted by Marfan syndrome, Loeys-Dietz syndrome, Vascular Ehlers-Danlos Syndrome, and related conditions. To learn more, visit marfan.org or meet us on social media:

Facebook | Instagram | LinkedIn | X (Twitter) | Threads | YouTube | TikTok

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Dr. Igel’s distinguished career spans both academia and clinical practice. As a Clinical Assistant Professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism at Weill Cornell Medicine, and an Attending Endocrinologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, Dr. Igel has demonstrated unparalleled expertise in the management of a wide range of endocrine disorders, with a specific focus on weight management, post-bariatric surgery care, type 2 diabetes, and other related conditions.

His commitment to advancing diabetes care is evident in his innovative approach, particularly in addressing the often-overlooked connection between diabetes and obesity. Dr. Igel emphasizes a weight-centric approach to diabetes treatment, advocating for medications that are either weight-neutral or lead to weight loss. This approach challenges the status quo in healthcare, where the impact of certain diabetes medications on weight gain is often disregarded.

“The link between diabetes and obesity is complex, and addressing it requires a comprehensive approach,” says Dr. Igel. “We know that over 11% of Americans have diabetes, and a large percentage are actually undiagnosed. Many individuals are in a progression towards diabetes, and much of that progression is closely tied to weight gain that occurs throughout someone’s lifetime. This is why we are committed to continuing our work to improve diabetes care and raise awareness of the critical connection between obesity and diabetes.”

“It is a privilege to recognize Dr. Leon Igel as the Medical Honoree of the Year,” said ADA’s Research Dinner Executive Committee Chair Gil Bashe, Finn Partners. “Obesity is a common, chronic, and progressive disease that is linked to a significant number of diabetes cases every year, and Dr. Igel’s dedication to reshaping diabetes care through his groundbreaking work in obesity management will help improve the lives of many people. His innovative approach and unwavering commitment are invaluable contributions to the field.”

As part of the Intellihealth team, Dr. Igel’s contributions extend beyond clinical practice. Intellihealth is at the forefront of leveraging innovative solutions to improve patient outcomes. Dr. Igel’s work with Intellihealth underscores the company’s dedication to advancing healthcare through research, technology, and patient-centered approaches.

For more information, sponsorships, and tickets, please go to www.diabetes.org/researchdinner2024.

About Intellihealth
Intellihealth is changing the perception of obesity and redefining how it is treated. We offer evidence-based medical obesity treatment that is three times more effective than lifestyle intervention alone. Our product, Evolve^™, enables health care providers to offer effective medical obesity treatment both via telehealth and in person. Our clinical services affiliate, Flyte^™ Medical, provides businesses and healthcare systems the services of experienced clinicians who are passionate about obesity medicine, including physicians, nurse practitioners and registered dietitians. More about Intellihealth, Evolve and Flyte Medical may be found at www.intellihealth.co.

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Hospital systems are experiencing increased cost of care due to workforce shortages, constrained bed capacity and increasing readmission rates.^i,ii Care-at-home programs, which typically include a virtual component, have proven to be effective in decreasing the length of stay and readmission rates which can result in the overall cost of care being reduced.^iii,iv Additionally, care-at-home programs can also support patient recovery and safety, with a potential reduction in fall risk and hospital acquired infections.^v Patients using remote solutions in their homes are three times more likely to be satisfied with the overall care experience.^vi

The goal of the GE HealthCare-Biofourmis collaboration is to enable more patients to go home earlier, and offer an alternative to facility-based care with the comfort and peace of mind that they are receiving high quality care at home with the intent of driving healthy behaviors in patients by managing them remotely. Moreover, insights from Biofourmis’ FDA-cleared, AI-guided algorithms can help care teams deliver efficient, personalized care at home.

“Biofourmis’ demonstrated success with care-at-home solutions will extend GE HealthCare’s current inpatient monitoring portfolio to support patient care from the hospital to home,” said Ashutosh Banerjee, GE HealthCare. “Combining our companies’ demonstrated capabilities will help revolutionize the way we approach the patient care journey as well as help address current challenges faced by health systems including hospital capacity issues and clinical staffing shortages.”

Biofourmis offers care-at-home solutions to deliver and enable care both virtually and in person using its digital platform, with FDA-cleared AI-guided algorithms, clinical-grade wearable devices, in-home services orchestration technology, and nursing services. The solutions provide numerous dynamic care pathways with questionnaire-branching logic to provide enhanced clinical context for care teams.

GE HealthCare’s FlexAcuity™ monitoring solutions in combination with GE HealthCare’s virtual care solutions like Mural ICU, Command Center and Digital CMU adapt to rapidly changing patient needs in the hospital and are built on a legacy of innovation. By offering Biofourmis’ virtual care-at-home solutions to customers, GE HealthCare can extend the care continuum beyond the hospital, and care teams can have a longitudinal patient view beyond the hospital setting.

Ross Armstrong, General Manager of Biofourmis Care, said: “Our collaboration will enable health systems and hospitals to leverage the power of technology and data in order to shape patient-focused solutions across the care continuum, no matter where the site of care is.”

GE HealthCare will begin distributing Biofourmis solutions to customers in the United States starting Q1 2024.

About Biofourmis

Biofourmis delivers technology-enabled solutions that bring the right care to any person anywhere. Biofourmis’ innovative solutions provide people everywhere with connected access to hospital-level services, virtual provider networks for remote care, in-home services, and life-changing clinical trials—all without leaving their homes. The company’s FDA-cleared AI-enabled analytics collect and analyze patient data in real time and identify shifts that can assist in supporting proactive interventions. Trusted by leading health systems, payers, biopharma companies and patients alike, Biofourmis’ connected platform improves patient outcomes, prevents hospital readmissions, aims to accelerate drug development, and closes critical gaps in care—ultimately making science smarter, healthcare simpler, and patients healthier. Biofourmis is a global technology company enabling care delivery, with headquarters in Boston and offices in Singapore and India.

About GE HealthCare Technologies Inc.

GE HealthCare is a leading global medical technology, pharmaceutical diagnostics, and digital solutions innovator, dedicated to providing integrated solutions, services, and data analytics to make hospitals more efficient, clinicians more effective, therapies more precise, and patients healthier and happier. Serving patients and providers for more than 100 years, GE HealthCare is advancing personalized, connected, and compassionate care, while simplifying the patient’s journey across the care pathway. Together our Imaging, Ultrasound, Patient Care Solutions, and Pharmaceutical Diagnostics businesses help improve patient care from diagnosis, to therapy, to monitoring. We are a $19.6 billion business with 51,000 colleagues working to create a world where healthcare has no limits.

ⁱ Fleron, A., Krishna, A., & Singhal, S. (2022, September 19). The gathering storm: The transformative impact of inflation on the healthcare sector. McKinsey & Company. https://www.mckinsey.com/industries/healthcare/our-insights/the-gathering-storm-the-transformative-impact-of-inflation-on-the-healthcare-sector

ⁱⁱ Massive Growth in Expenses and Rising Inflation Fuel Continued Financial Challenges for America’s Hospitals and Health Systems. American Hospital Association. (2022, April). https://www.aha.org/system/files/media/file/2022/04/2022-Hospital-Expenses-Increase-Report-Final-Final.pdf

ⁱⁱⁱ Levine DM, Ouchi K, Blanchfield B, Saenz A, Burke K, Paz M,Diamond K, Pu CT, Schnipper JL. Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. Ann Intern Med. 2020 Jan21;172(2):77-85. doi: 10.7326/M19-0600. Epub 2019 Dec 17. PMID: 31842232.

^iv Leff B, Burton L, Mader SL, Naughton B, Burl J, Inouye SK, Greenough WB 3rd, Guido S, Langston C, Frick KD, Steinwachs D, Burton JR. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med.2005 Dec 6;143(11):798-808. doi: 10.7326/0003-4819-143-11-200512060-00008. PMID: 16330791.

^v Telehealth: Helping hospitals deliver cost-effective care.American Hospital Association. (2016, April 22). https://www.aha.org/system/files/content/16/16telehealthissuebrief.pdf  

^vi Leff B, Burton L, Mader S, Naughton B, Burl J, Clark R, Greenough WB 3rd, Guido S, Steinwachs D, Burton JR. Satisfaction with hospital at home care. J Am Geriatr Soc. 2006 Sep;54(9):1355-63. doi:10.1111/j.1532-5415.2006.00855.x. PMID: 16970642.

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ARC Innovation and Sheba Medical Center, Israel’s largest medical center and a Newsweek ranked world’s best hospital for the last five years, announced today the integration of technology developed by two startups, Cognishine and Kemtai, to augment healthcare in the hospital’s newly expanded rehabilitation ward.

Sheba Medical Center is home to Israel’s largest rehabilitation hospital. Amid the Israel-Hamas war, Sheba expanded the hospital with the addition of a new state-of-the-art 36-bed ward to treat wounded soldiers. The new ward leverages a range of innovative digital medical technologies to augment medical staff capabilities and improve overall quality of care. 

“Now is the time to innovate. During the COVID pandemic, Sheba created innovative solutions to save lives and helped set the health protocols for the rest of the world,” said Prof. Eyal Zimlichman, Chief Transformation Officer and Chief Innovation Officer at Sheba Medical Center and Director and Founder of ARC Innovation. “Times of crisis present an opportunity to accelerate innovation and transformation in care. And this is exactly what we are setting out to do, given the immense need for rehabilitation in Israel at this time.”

To maximize the effectiveness of the new ward, Sheba called upon Israel’s startup ecosystem, inviting health tech companies to submit solutions for potential use in the rehab hospital. Out of 82 companies that applied to the project, eight were selected to pitch their solutions to a panel of Sheba clinicians and industry leaders. Out of these eight companies, Cognishine and Kemtai were selected to begin a pilot program at Sheba, with the aim of incorporating the solutions into day-to-day rehab treatment.

Cognishine’s digital platform supports therapists in providing effective care for cognitive, emotional, speech and language disorders. Digitizing traditional therapeutic processes, the company offers a wide range of activities based on real-world scenarios to help patients to regain cognitive, speech and social-emotional capabilities.

“Cognishine extends the reach of medical professionals, enabling them to continue providing care through digitized therapeutic activities aiding cognitive abilities,” said Nimrod Zilkha, Co-Founder & CEO of Cognishine. “We are honored to play a role alongside Sheba helping soldiers recover from the war and get back to their daily lives.”

Kemtai is an AI-powered exercise platform for physical therapy and rehab, compatible with most phones and computers. The app provides real-time feedback and corrective guidance during exercise, enabling patients to improve their performance and accelerate recovery.

“Kemtai is enabling patients to fully adhere to their rehabilitation exercises with AI-guided, real-time guidance, helping achieve the best possible outcomes,” said Dr. Mor Amitai, CEO of Kemtai. “Our pilot at Sheba will see even more patients with physical limitations recover through augmented exercise.”

# # #

About Sheba Medical Center

The largest and most comprehensive medical center in the Middle East, Sheba Medical Center, Tel Hashomer is generating global impact through its medical care, research and healthcare transformation. Sheba’s City of Health boasts acute-care, rehabilitation, children’s, cancer and geriatric hospitals, research and innovation hubs, medical simulation center and center for disaster response on one comprehensive campus in the center of Israel. Sheba serves as a true hospital without borders, welcoming patients and healthcare professionals from all over the world and consistently providing the highest-level medical care to all in need. Sheba has been ranked a World’s Best Hospital by Newsweek five years in a row (2019, 2020, 2021, 2022, 2023). For more information, visit: https://sheba-global.com/

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Amid rising inflation, annual family premiums for employer-sponsored health insurance climbed 7% on average this year to reach $23,968, a sharp departure from virtually no growth in premiums last year, the 2023 benchmark KFF Employer Health Benefits Survey finds.

On average, workers this year contribute $6,575 annually toward the cost of family premium, up nearly $500 from 2022, with employers paying the rest. Future increases may be on the horizon, as nearly a quarter (23%) of employers say they will increase workers’ contributions in the next two years.

Workers at firms with fewer than 200 workers on average contribute nearly $2,500 more toward family premiums than those at larger firms ($8,334 vs. $5,889). In fact, a quarter of covered workers at small firms pay at least $12,000 annually in premiums for family coverage.

This year’s 7% increase in average premiums is similar to the year-over-year rise in workers’ wages (5.2%) and inflation (5.8%). Over the past five years, premiums rose 22%, in line with wages (27%) and inflation (21%).

Among workers who face an annual deductible for single coverage, the average this year stands at $1,735, similar to last year. The average deductible amount has increased 10% over the last five years and 53% over the last ten years.  Workers at small firms (under 200 workers) on average face much larger deductibles than workers at larger firms ($2,434 vs. $1,478).

The modest rise in deductibles may reflect employers’ perceptions about the burden of cost-sharing on workers.  More than half (58%) of employers say that their workers have at least a moderate level of concern about the affordability of their plan’s cost-sharing requirements.  

“Rising employer health care premiums have resumed their nasty ways, a reminder that while the nation has made great progress expanding coverage, people continue to struggle with medical bills, and overall the nation has no strategy on health costs,” KFF President and CEO Drew Altman said.

Almost 153 million Americans rely on employer-sponsored coverage, and the 25th annual survey of more than 2,100 small and large employers provides a detailed picture of the trends affecting it. In addition to the full report and summary of findings released today, the journal Health Affairs is publishing an article with select findings online. The article will also appear in its November issue.

Some Large Firms Do Not Cover Legal Abortions; Others Do But with Restrictions

In the wake of the Supreme Court’s June 2022 decision that ended the federal constitutional right to abortion, states have adopted a range of new laws to prohibit or severely restrict access to abortion, creating challenges for large employers with workers in multiple states.

Among all large firms (with at least 200 workers), one in ten (10%) say that their largest plan does not cover legal abortions under any circumstances. An additional 18% say they only cover legal abortions under limited circumstances, such as in cases involving rape, incest, or health or life endangerment.

In contrast, nearly a third (32%) of large firms say they cover legal abortions in most or all circumstances. Another four in ten (40%) say they were unsure of their plan’s abortion coverage, potentially because their policies were in flux or they were unaware of the details.

With abortion banned or severely limited in some states, 7% of large employers say that they provide, or plan to provide, financial assistance for travel expenses for enrollees who have to go out of state to obtain a legal abortion. Very large employers (with at least 5,000 workers) are most likely to provide, or plan to provide, such travel reimbursements (19%).

Concerns Persist About Adequacy of Mental Health and Substance Use Networks

Among large employers (with at least 200 workers) that offer health benefits to at least some workers, the vast majority (88%) say their plan has enough primary care doctors to provide timely access for enrollees. Substantially fewer say the same about their mental health (59%) and substance use condition (58%) networks.

Nearly one in five (18%) of large offering firms say that they took steps in the past year to increase the number of mental health providers in their largest plan’s network. This includes 44% of the largest employers (with at least 5,000 workers).

On the other hand, one in five (21%) of large offering employers say their plan has limits on the number of covered mental health services, potentially restricting access for enrollees with long-term needs.

“For several years now, the survey has shown that many large employers do not believe that their networks have enough mental health providers to provide timely access to care. In 2023, many large employers, including nearly half of the largest employers, say that they are taking steps to better meet enrollees’ needs,” said Gary Claxton, a KFF senior vice president and director of the Health Care Marketplace Project, the lead author of the study and also of the Health Affairs article.

Other findings include: 

• Offer rate. Nearly all employers with at least 200 workers offer health benefits to at least some workers, though smaller firms are increasingly less likely to offer health benefits as they get smaller. For example, 83% of firms with 10 to 199 employees offer health benefits to at least some of their workers, while just 42% of firms with three to nine workers do so.
• Dental, vision and long-term care insurance. Among firms offering health benefits, most also offer separate dental coverage (91%) – double the share that did so in 2010 (46%). Most also offer vision (82%) insurance, also up sharply since 2010 (17%). Fewer offer long-term care insurance (26%).
• Coverage for gender-affirming surgery. Among employers with at least 200 workers, 23% cover gender-affirming survey in their largest health plan. More than a third (37%) say they do not cover such surgeries, while a large share (40%) are not sure about such coverage. Among the largest firms (at least 5,000 workers), nearly two thirds (62%) cover gender-affirming surgery, many of which expanded the benefit in the past two years.
• Centers of Excellence. About one in five (19%) offering employers with at least 200 workers say their plan includes a “center of excellence” program for specific services, either limiting enrollees to a narrower group or providers or offering lower cost-sharing for doing so. Among these firms, 22% have introduced a new center of excellence program within the last two years. Among firms with a center of excellence program, 45% had a program for joint replacement, 42% for back or spine surgery, 31% for bariatric surgery, 30% for mental health, and 28% for substance use disorders.

Methodology

KFF conducted the annual employer survey between January and July of 2023. It included 2,133 randomly selected, non-federal public and private firms with three or more employees that responded to the full survey. An additional 2,759 firms responded to a single question about offering coverage. For more information on the survey methodology, see the Survey Design and Methods Section.

ABOUT KFF:

KFF is the independent source for health policy research, polling and news.

ABOUT HEALTH AFFAIRS:

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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Such problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and delays and denials of care that involved an insurer’s prior authorization. 

At least half within each of four major types of health coverage – employer, Medicaid, the Affordable Care Act’s marketplace, and Medicare – say they had a problem using their coverage in the past year. 

Such problems are more common among people with greater health care needs. For example:

• Two-thirds (67%) of consumers who rate their own health as “fair” or “poor” encountered a problem in the past year.
• About three-quarters (74%) of those who received mental health treatment in the past year reported a problem.
• More than three-quarters (78%) of those who received a lot of health care (more than 10 provider visits in the past year) reported a problem.

“The survey shows that the sheer complexity of insurance is as big a problem as affordability, particularly for those with the greatest needs,” KFF President and CEO Drew Altman said. “People report an obstacle course of claims denials, limited in-network providers, and a labyrinth of red tape, with many saying it prevented them from getting needed care.”

Today’s report captures key results from the nationally representative survey of 3,605 people with health coverage through an employer, Medicare, Medicaid or the Affordable Care Act’s marketplaces. Future reports will delve more deeply into the experiences of people with those types of coverage, as well as people with specific chronic conditions and needs across types of insurance.

The frequency that people encounter specific insurance problems varies by type of coverage. For example, people with employer and marketplace coverage report denied claims more often than people with Medicare or Medicaid, and people with Medicaid and marketplace coverage more often report problems finding in-network providers.

Insurance problems can contribute to unexpected costs, with more than a quarter (28%) of those who reported problems saying they had to pay more for their care as a result. This includes about a third of those with marketplace or employer coverage who reported problems in the past year.

Among those who reported recent insurance problems, half say they were able to resolve the issue to their satisfaction, while nearly as many say either that the issue had been resolved in a way they didn’t like (28%) or that it remained unresolved (19%). Most insured adults (60%) do not know they have appeal rights by law, and three quarters (76%) do not know what government agency to call for help dealing with their insurance.

Consumers’ insurance problems can affect their ability to get timely, needed care. Among those with recent problems, about one in six say that they were not able to get recommended care (17%), they faced a significant delay in receiving such care (17%), or their health declined (15%) as a direct result.

About half (51%) of insured adults report some difficulty understanding at least one aspect of their health insurance, such as what their insurance will cover (36%), what they will owe out-of-pocket for care (30%), or what their explanation of benefits statement means (30%). About a quarter say that they find it difficult to understand terms such as “deductible” or “copay” (25%) and to figure out which doctors, hospitals and other providers are in network (23%).

People with Mental Health Challenges Have More Problems

The report also probes the challenges facing insured people who rate their mental health as fair or poor, regardless of whether they sought or obtained mental health treatment. This includes about one in five of all people with insurance, and one in three of those with Medicaid coverage.

Substantial shares of enrollees in this group rate the availability (45%) and quality (37%) of mental health therapists and providers covered by their insurance as “fair” or “poor.” 

Among those who say their own mental health is fair or poor, 43% say that there was a time in the past year when they did not get needed mental health care. Among young adults under age 30 who describe their mental health as fair or poor, more than half (55%) say they did not get needed mental health care in the past year.

People cite various reasons for not getting needed mental health care, but insurance was a factor for many.  Among all insured adults who didn’t get needed mental health care, more than four in 10 (44%) say they couldn’t afford the cost, and more than a third say it was because their insurance wouldn’t cover it. 

• One in six (16%) of all insured people say they have had problems paying or an inability to pay for medical bills in the past year, including similar shares of those with marketplace (19%), employer (17%), and Medicaid (16%) coverage, as well as 12 percent of people with Medicare.
• Premiums also can be an issue for consumers, particularly for those with employer and marketplace plans.  About half of those with marketplace or employer coverage give their insurance plan low marks for the amount that they pay in premiums and the amount they pay out-of-pocket to see a doctor. Far fewer of those with Medicare or Medicaid rate those aspects of their coverage negatively.
• In spite of the problems people report using their insurance, a large majority (81%) give “excellent” or “good” ratings when asked to rate their insurance overall. 
• Large majorities of consumers with insurance say they would support requirements on insurers that could make it easier to avoid or resolve insurance problems. These include requirements to maintain accurate and up-to-date information about who is in their network (91%) and to provide simpler, easier-to read statements explaining coverage decisions and how to appeal if you disagree (94%), all of which have been enacted by Congress though not all have been implemented.   

Designed and analyzed by public opinion researchers at KFF, the KFF Survey of Consumers Experiences with Health Insurance was conducted February 21-March 14, 2023, online and by telephone among a representative sample of 3,605 adults in the U.S. with health insurance coverage, including 978 adults with employer-sponsored insurance, 815 adults with Medicaid coverage, 885 adults with Medicare, and 880 adults with marketplace insurance. Interviews were conducted in English and in Spanish. The margin of sampling error is plus or minus 2 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher. 

The post KFF Survey Shows Complexity, Red Tape, Denials, Confusion Rivals Affordability as a Problem for Insured Consumers, With Some Saying It Caused Them to Go Without or Delay Care appeared first on Medika Life.

The clinics, spread over two floors and 180 sqm, will house a resident OB-GYN and pediatrician with access to the latest medical technology. Expectant mothers will also benefit from on-site birthing facilities in a country with high maternal mortality.  The pilot clinics will be built in Albay, a rural region of Luzon, the Philippines’ largest island. The Philippines is home to approx. 140 million people, many of whom still live below the poverty line.

“Statistics tell the relentless story of needless suffering and death,” reflects Clinics IV Life Founder. Robert Turner.  “For decades we’ve thrown billions of dollars in aid each year at the problem. It remains and, in many instances, worsens year to year. Historical charitable models are flawed.”  Turner adds: “Clinics IV Life was launched by seasoned health professionals who seek to address these shortcomings in novel ways. Our hybrid clinic model removes the need for continued donor funding and integrates into local healthcare systems, removing the dependencies created by historical charitable efforts.”

Each clinic aims to treat 1000 indigent patients annually, making inroads on the high maternal and infant mortality levels plaguing developing nations. The first of the three clinics earmarked for Luzon will open in 2024, followed by openings in late 2024 and 2025. Access to care remains one of the critical reasons mothers die in childbirth.  The leading causes of maternal mortality in the Philippines – like in many emerging nations – include challenges that can be prevented with medical oversight, such as bleeding, infection, unsafe abortion, hypertensive disorders and obstructed labor.

A NEW ECONOMIC MODEL FOR SUSTAINABILITY

Their clinic model relies on a unique shared practice agreement that ensures its clinics are self-sustaining, removing the need for the continued use of donor funds beyond construction and equipping a site. The Not-for-Profit plans to extend its reach into India, Africa and other Asian countries during the next three years.

Unlike traditional charitable models, Clinics for Life will not seek funding from the general public. 

“We form close corporate partnerships with companies that serve the maternal and newborn health markets and share our vision. Our clinic model offers the best ROI in terms of corporate giving. We pair each clinic with a corporate partner and for a single donation a company can generate more than 30 years of health impact in a community. It’s a gift that keeps on giving; both for the patients and the donors,” says Kemi Olugemo, chair of Clinics IV Life’s Fundraising Board, on their approach to funding.

ABOUT MATERNAL AND INFANT MORTALITY 

Every minute, around the globe, four newborns die; every two minutes, an expectant woman dies, often in childbirth. It is estimated that 85% of these deaths, primarily occurring in developing countries, are avoidable with access to proper medical care. In India alone last year, 2.7 million babies were stillborn, and nearly 600 thousand died in their first month.

Historically, women suffer more from health inequalities and require more complex medical interventions than their male counterparts on a more frequent basis. Access to procedures taken for granted in developed nations, like ultrasounds and fetal monitoring, are luxuries in developing countries, only affordable to those with money. 

ABOUT CLINICS IV LIFE 

Clinics IV Life was created specifically to address these health inequities that are commonplace in emerging nations. Their hybrid clinic model overcomes continued reliance on donor funding by creating self-sustaining businesses, obviating the need for financial donor support to ensure the ongoing success of each clinic. Donor funds are only utilized for the construction and equipping of a clinic.

Clinics IV Life views every element of the patient-provider ecosystem as being of equal value, and places great emphasis on ensuring its doctors, nurses and staff can serve their patients in a safe, secure and welcoming environment while having access to the latest medical technology and training and a global network of knowledge provided by colleagues who selflessly volunteer their time and skills.

The Clinics IV Life board of directors includes physicians, pharmacists, psychologists, public health professionals and business leaders who have brought their knowledge, connections and resources to this needed cause.  

Find out more by visiting: https://clinics4life.com/

Clinic IV Life Board members and industry advisors include: 

• Robert Turner – Founding Board Member
• Kemi Olugemo MD FAAN – Chair, Fundraising and Board of Directors
• Shazia Ahmad
• Gil Bashe – Board of Directors
• Grace Delerme
• Hesham Hassaballa MD
• Sharon Handelman-Gotlib
• Karie Hudson MS
• Viveca Livezey MD FAAN
• Jeff Livingston MD, Board of Directors
• Kellie Lease Stecher MD
• Dr. Soojin Jun
• Tom Krohn
• Teresita Pulgarin 
• Bianca Rose Phillips LLB. BComm. GradDipLP. LLM 

Media Contacts:

Kemi Olugemo, MD, FAAN
Board Chair, Fundraising
Tel: +1 (781) 226 0429
Email: kemi.olugemo@clinics4life.com

Gil Bashe
Board Chair, Executive
Cell: +1 (732) 371-0922
Email: gil.bashe@finnpartners.com

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London, January 30, 2023 – The journal, Artificial Intelligence in the Life Sciences (AILSCI), published by Elsevier, is set to release a special Themed Article Collection (TAC): Women in AI in the Life Sciences. Many female scientists have spearheaded ground-breaking research in this field, but despite their invaluable contributions, they often do not receive the visibility they deserve.

AILSCI is on a quest to help female scientists get recognised for their contributions and to enhance the visibility of their work in the field of AI in the life sciences. This TAC will showcase the contributions driven by young and late-stage investigators—stellar scientists in their own right—who solve biomedical-, healthcare-, or chemistry-based research problems using AI.

AI, encompassing various disciplines including, among others, machine learning (ML), natural language processing, and computer vision, has significantly impacted human life. Over the last decade, it has turned into the driving force behind many emerging technologies. Its applications are embedded in our daily lives as voice assistants, image recognition software, food delivery apps, navigation apps, and much more. Interestingly, AI applications also play a significant role in the highly complex and interdisciplinary field of life sciences.

The journal is aiming to invite women to showcase their research in the AI arena, even if they may feel less confident, due to limited opportunities. As increasingly more female scientists come to the forefront to share their accomplishments, they will indeed be a source of inspiration for new entrants in the field of AI.

Female investigators report that it is still common for women’s inputs to be neglected by team members during discussions. At times, their ideas are repeated by other colleagues, and hence, falsely considered as the other person’s contribution. As a result, women in AI, especially new entrants in the field, tend to suffer from impostor syndrome and may gradually begin to participate less in public events.

These issues are heightened by salary inequities for women in the field. Such challenges, attributable to an unconscious gender bias in the workplace, make the AI industry trickier to navigate for a woman.

In late 2022, AILSCI hosted a webinar to discuss and recognise women’s contributions to the practical applications and theoretical advances of artificial intelligence in the life sciences, and the challenges they face in the industry. During the webinar, one of the panellists, Dr. Raquel Rodríguez-Pérez, Principal Scientist at Novartis Institutes for BioMedical Research, talked about how she uses ML and data science to predict particular properties of new compounds. It helps her immensely with decision-making, from prioritising compound modifications to narrowing down future experimental directions.

Similarly, Dr. Rebecca Swett, a Senior Scientist at Relay Therapeutics, talked about how she optimises synthesised compound libraries using ML. She makes use of an aggressive ML cycle, where AI is applied to multiple aspects of drug design to generate high-quality, accurate models for candidate drug compounds.

The webinar led to a candid and engaging discussion, in which multiple solutions were proposed on how organisations such as AILSCI can tackle an unconscious bias against women. The panellists stressed that inviting female investigators to submit their manuscripts could be a good start. Attendees also nominated female scientists for the AILSCI editorial board to invite to join future events planned for this special collection.

Submissions to the Special Issue on Women in Artificial Intelligence in the Life Sciences are open until 30 June 2023.

***

Notes for editors

The special TAC issue can be accessed here. You can also watch the key highlights of the webinar here.

The webinar was hosted by AILSCI’s Editor-in-Chief, Dr. Jürgen Bajorath; Associate Editor, Dr. Carolina Horta Andrade, and Guest Editors Dr. Melissa R. Landon and Dr. Steve Gardner. It saw prominent scientists Dr. Raquel Rodríguez-Pérez, Principal Scientist at Novartis Institutes for BioMedical Research and Dr. Rebecca Swett, Senior Scientist at Relay Therapeutics as the two panellists.

About the Journal

Artificial Intelligence in the Life Sciences (AILSCI), published by Elsevier, is an open access journal that provides a scientific forum for the latest ground-breaking research on the practical applications and theoretical advances of AI in the life sciences and related disciplines. AILSCI’s themed article collection: Women in AI in the Life Sciences aims to recognise and celebrate the invaluable contributions of women researchers and authors in this field and take efforts to remove the unconscious bias against women that prevails in research. Women in AI in the Life Sciences is intended to support and inspire both young investigators as well as established female leaders to contribute to the field.

About Elsevier

As a global leader in information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making for customers across the global research and health ecosystems.

In everything we publish, we uphold the highest standards of quality and integrity. We bring that same rigor to our information analytics solutions for researchers, health professionals, institutions, and funders.

Elsevier employs 8,700 people worldwide. We have supported the work of our research and health partners for more than 140 years. Growing from our roots in publishing, we offer knowledge and valuable analytics that help our users make breakthroughs and drive societal progress. Digital solutions such as ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath support strategic research management, R&D performance, clinical decision support, and health education.

Researchers and healthcare professionals rely on over 2,700 digitised journals, including The Lancet and Cell, over 43,000 eBook titles, and iconic reference works such as Gray’s Anatomy, published by Elsevier. With the Elsevier Foundation and our external Inclusion & Diversity Advisory Board, we work in partnership with diverse stakeholders to advance inclusion and diversity in science, research, and healthcare in developing countries and other regions of the world.

Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. www.elsevier.com

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