The Future of Healthcare: AI, Federal Policy, and Financial Pressures

Navigating the Future of Healthcare: Insights from the Capstone Conversation Podcast**

Welcome to the Capstone Conversation, where listeners are brought up to speed on critical topics affecting the Greater East Bay region. In this episode, host Jared Asch explores the rapidly evolving landscape of healthcare, examining technological advancements, legislative changes, and the impact of recent federal policies on hospitals across Northern California. Joining him is Bryan Bucklew from the Hospital Council of Northern and Central California, offering a front-row perspective on the challenges and opportunities facing the healthcare industry.

Listen to the full interview on your favorite podcast app by typing in "Capstone Conversation" or via this direct link.

Technology and Telehealth: A Post-COVID Perspective

As the world recovers from the COVID-19 pandemic, one clear lesson has emerged: technology, particularly telehealth, is transforming the way healthcare is delivered. Bryan notes that telehealth has become a standard procedure, facilitating more efficient and effective care. Initially supported by temporary waivers, telehealth services have dramatically improved healthcare accessibility across both rural and urban areas. This shift has enabled remote diagnosis and treatment, which were previously required to be in-person visits.

Facing Legislative and Financial Hurdles

Bryan highlights the complexity of healthcare regulation in the U.S., a product of multi-level governance. With temporary waivers still in play, the future of telehealth depends on policy decisions at the state and federal levels. Additionally, the implementation of the "big beautiful bill" looms—a legislative overhaul poised to significantly reduce funding for healthcare programs, including Medi-Cal, which covers a substantial portion of California’s population.

Economic Implications: A Looming Fiscal Storm

The financial ramifications of reduced funding are extensive. Bryan outlines that hospitals in regions like Alameda and San Francisco face potential revenue losses in the hundreds of millions. The repercussions extend beyond economics, threatening to disrupt service availability and accessibility. With healthcare costs already a contentious topic, impending cuts may exacerbate uninsured rates, leading to a surge in uncompensated care that threatens the sustainability of healthcare providers.

The Role of AI in Healthcare's Future

The conversation turns to the integration of artificial intelligence in healthcare. Rather than replacing jobs, AI enhances efficiency, allowing medical professionals to focus on patient care. Diagnostic procedures, administrative tasks, and telehealth consultations benefit from AI's capabilities. Hospitals, particularly in tech-savvy regions such as the Bay Area, are leveraging AI to enhance healthcare delivery and improve cost management.

Community Engagement and Advocacy

Bryan emphasizes the importance of public awareness and advocacy. He urges individuals experiencing difficulties with healthcare access to reach out to their elected officials. These personal stories can influence policy decisions and spotlight the need for sustainable healthcare reforms.

Conclusion: A Call to Action

The podcast concludes with a call to remain vigilant as the healthcare landscape undergoes transformational changes. Hospitals and healthcare systems are grappling with a confluence of challenges—financial constraints, technological advancements, and evolving regulatory environments. As these dynamics unfold, continued engagement from both the public and policymakers will be critical to ensuring a robust and accessible healthcare system in the years to come.

Join us next time on the Capstone Conversation as we continue to explore vital issues shaping our region and beyond.

#HealthcareTransformation #NorthernCalifornia #Telehealth #AIinHealthcare #HealthPolicy #COVID19Lessons #HospitalFunding #HealthcareAdvocacy #RuralHealthcare #UrbanHealthcare #HealthTech #HospitalCouncil #PolicyChange #HealthcareInnovation #PatientCare #Medicare #Medicaid #HealthcareAccess #LegislativeAction #HealthcareEconomics #SeismicRegulations #PublicHealth #HealthcareReform #HospitalChallenges

For a Full Transcript

Welcome to the Capstone conversation where you learn about what's happening in the Greater East Bay. I am your host, Jared Asch.

  Today, we are gonna look at the rapidly changing field of healthcare and hospitals throughout Northern California. We're gonna take a look at how technology is changing in the use of ai. We're gonna look at lessons learned and the world post COVID and.

One of the hot topics is what are the impacts of the big beautiful bill from the feds here and how does it impact local hospitals in California? So today I am join joined by Bryan Bucklew of the Hospital Council of Northern and Central California.

Bryan thank you for joining us.

We are part of the whole family of the California Hospital Association. There's three regional associations in California, San Diego and Imperial Counties, and then the Hospital Association of Southern California, which covers the six Los Angeles counties.

And then you have the Hospital Council of Northern Central California. We represent 50 of the 58 counties. So we go basically from San Luis Obispo over to Visalia, all the way up to the Oregon border. From the Pacific Ocean over to Nevada. So very diverse area. And so in our area we have hospitals that have eight beds, and then we have hospitals that have, well over a thousand beds.

And then located in urban areas such as San Francisco, Oakland, Sacramento, Fresno, to very rural areas where there's not another hospital within a hundred miles So critical access rural hospitals, nonprofit hospitals, investor owned hospitals, county hospitals district hospitals.

So we really cover the gamut in our 50 county service area. And we have about, we represent about 214 hospitals in that area.

That is a big and very diverse region to keep your hands on. So I appreciate that. How long have you been in the organization and what is your background?

I moved here and my family moved here about seven years ago. Almost to the day. We moved. I was here a couple months earlier than my family.

the rest of my family moved the day of the Paradise Fire. That was something that is indelibly etched in our memory. I came from Ohio. in Ohio I, ran the greater Dayton Area Hospital Association, which represented hospitals in the Dayton, Cincinnati area. before that I was involved in economic development, running public policy and economic development for the regional chamber.

There. And then before then I was district director for the member of Congress from the, from that area. But I've been involved in healthcare now for almost 25 years. So it's evolved a lot in those 25 years, and it's evolved a lot in the last 25 minutes it feels like.

Use that as the lead in. Let's talk post COVID. There was a lot of lessons learned. A lot of staff have burned out. What have we learned? What are we doing to improve going forward in the hospital network here?

Yeah, there's some. Positives that came outta COVID. So we've been able to deliver care, I believe, more efficiently and effectively through telehealth and realizing that sometimes the most efficient, effective way to get care to somebody is maybe not visiting in person.

So telehealth has become more of a standard operating procedure. We're still operating on some waivers and some exemptions right now, but overall, I think that's increased the accessibility to healthcare for a lot of individuals. And so that's something that we found out during COVID.

Also during COVID, we found out that, our system has been set up, not to focus in on inpatient and has really been focused in on the outpatient. So the number of beds have decreased per capita. And the reason for that is for a number of things. One, we have a lot shorter length of stays, and that's primarily because the technology has increased so significantly in the past.

I remember when I was a kid of six or seven years old and I had my tonsils. And adenoids taken out. That was a three day hospital stay. And now you're lucky to be in if you're even in a hospital or you may be in a surgery center that's maybe a three hour procedure from the time you show up to the time that you leave.

So the medical technologies increased dramatically, which requires. Less of an inpatient footprint, but the requirements for hospitals to be available 24 7, 365 days a year remains. And hospitals, what we found out during COVID are really the bedrock of the healthcare system. And so when issues came up during COVID, whether it was the identification of testing

Distribution of vaccines. It all went through the hospitals. It didn't go through really the public health entities in the state or at the county level. They were really going through the hospitals, and the hospitals were looked to as leaders in that area. And I think that continues today.

We had to basically figure out overnight The first time that I remember hearing COID was in late January of 2020. And then the first case that we know of in Northern California and really all of California and one of the first in the entire country was at North Bay Health which is in the central coast area in the East Bay area.

I remember getting a call on February 29th. And they had taken a test and at that time you had to send those tests back to Atlanta. So you weren't able to process the test remotely. You had to go back to the CDC and that test was administered about eight days prior to them getting notified on February 29th.

And at that time, you had a number of people going in and out of that room where that patient was. And it was a very challenging time, and by February 29th to basically March 16th, the entire state and the entire country shut down in those two weeks. So it was a very quick period of time where everybody was trying to figure out a.

What was going on? How do you identify it? And more importantly, how do you treat it? And how do you make sure that the healthcare system is set up to do that? So basically you're learning to fly the plane while you're building it. And it was a very challenging set of circumstances.

One of the more fascinating things I took away with what you said is that tonsil surgery is going from three days to three hours. Really has to do with recovery the process for the procedure the use of laser. On the telehealth side that you talked about, where are people seeing the biggest uptick?

Is it in those rural areas who have to drive 30, 50 miles to a doctor? Or is it in the urban areas? 'cause it's just more accessible. I know I've had. Doctors in Southern California do telehealth, which was easier to get appointments with than people here in the Bay Area in person.

This is one of those circumstances that's somewhat unique to healthcare, that it's ubiquitous across the system.

So there's benefits in the rural areas and the critical access areas benefits in the urban areas. Also in the suburban areas. And what it does is it allows the dissemination and the identification of certain ailments to be able to be done remotely and then being able to get treated for that remotely.

When I had COVID I had a video appointment and I was able to get prescribed the medicines all remotely. I didn't have to go in at all. To the facility. And so I think that brings more access and that's a critical component to what you're looking for in healthcare is making sure people have access to the care that they need when they need it.

So our mantra is how do you get people the right care at the right time in the right facility for the right cost? And telehealth really. Helps move that forward. Prior to COVID you really had to go in to get a prescription. Prescriptions weren't done via telehealth and this really fast forwarded the regulatory process to approve telehealth.

COVID really normalized that process and made everyone realize that there was a capacity to really provide some access and some treatment. And that telehealth medium.

You talked about they're still on waivers,

is that going through the legislature to pass a bill to clarify that and allow that long term or What is needed from a policy perspective?

Yeah. There, there's a couple things. So one the way the healthcare system is set up in our country is a conglomeration number of different rules, regulation and legislation that happens at the local, state and federal level.

And not all of those, work well together. And so part of this is some CMS which is the Center for Medicaid and Medicare Services, which is part of HHS, which is the federal regulatory body. Some of this is the state. And those are the two major areas where, you get flexibility on waivers that are done for a certain period of time, and at some point of time those waivers expire.

For example, during COVI hospitals were able to get waivers for flex space, meaning that you could treat patients in non-traditional areas of the hospital because you needed the room and you were able to get some flex space waivers for that. Hospitals to set up triage areas and parking lots.

And so individuals that potentially had COVID didn't need to physically come into the facility to get tested. They could be tested in the parking lots. All of those have waivers. And healthcare has a significant legislative and regulatory requirement. And in California. It is more robust. And that's a politically correct way of saying that the legislative and regulatory culture in California is much more significant than any other state in the entire country.

I have experience in other states specifically Kentucky, Indiana, Ohio. Much different regulatory process than we have here in California. Some of it's good, some of it's challenging, and some of it's maybe not necessary, but it's the waters in which we swim in and that we have to deal with.

For those of you just listening on the audio, you can see my shocked face because California has more regulations than any other state. I didn't think that would be possible. There are these things that. the agency, the legislature are starting to look at like how to evolve longer term or are they happy with some waivers and see where things go in the next couple of years?

I think there's a couple of things. state and federal governments. Private payers wanna make sure that what they're paying for healthcare has some checks and balances. So that's why you have some of these temporary waivers. previously there was some concern that.

Why would you pay a physician or a hospital the same amount for a telehealth visit as for an in-person visit? as they go through those public policy discussions they know that. At least from a temporary standpoint, keeping the telehealth policies in place makes a lot of sense because it provides access to individuals.

It's a legislative regulatory issue. And I think the challenge is that and I think for your listeners, if you go into a hospital today or a doctor's office today. Generally let's, I'll leave it at hospitals 'cause I'm more, much more familiar there. On average, you're gonna have somewhere between 70 to 82% of the individuals in that facility, in that hospital on a government plan, either a Medicare or Medicaid plan.

And the vast majority of those costs are not are those hospitals are getting, and physicians are getting reimbursed at less than it takes. So if you can imagine you're gonna open up a business and say, Hey, we're gonna guarantee that there's gonna be demand for your product or service.

You have to be open 24 hours a day, 365 days a year, seven days a week, and there'll be unlimited customers coming through your door. But you're gonna lose money on 80% of the people walking through your door. I'm not sure many people would want to go into that business. And so that's the challenge that we have in the healthcare industry.

And the other challenge that we have is, it is not set up to make long-term financial. Systemic change in the system. And the reason for that is when you have 80% of your patients being covered by either the state or federal government or a combination thereof it is more looked as a budget item that has to be approved

One year or every two years in terms of how much you're paying for certain types of services. And that makes it very difficult to do some long-term planning associated with that. And the healthcare economics follows no other rational economic model. And I remember doing a lot of town hall meetings during the Affordable Care Act or Obamacare.

And I did, town hall meetings where the predominantly, the number of people there were supportive of universal payer and then others that were a tea party back in the day where they wanted the free markets.

Free market should dictate healthcare. But as soon as you start talking to him about. Medicare, which is not part of the free market. Then he is don't take away my Medicare. That's a significant part of the healthcare system. And you have to get in the. Philosophical, but it gets down into the into realistic is if you look at everyone that participates in the healthcare system, the incentives are not aligned to figure out how to get you the best care at the best price.

because you have incentives from all the different players in healthcare, whether you look at physicians, medical equipment suppliers, pharmaceutical companies, insurance companies, whether they're for-profit or not for-profit, Medicare, Medicaid. Some of their goals are they're ultimate customers, the shareholder, some of those are the patient. But none of those are aligned. And when you have a system that has so many different players and they have so many different end users that they're looking to satisfy it makes it very challenging to do systemic and fundamental change.

I wanna. Hit on that. You said, so if I look at all the hospitals, like in the Bay Area as an example, right? There's a lot of big ones. Sutter Health has multiple hospitals. You've got UCSF, children's, Benioff, Kaiser all of those. You're saying John Muir, 72 to 80%. Stanford Health is government backed.

Okay. So let's. Use that as the pivot point to dive into the one big beautiful bill. Tons of changes to both of those federal programs. And a lot of impact to the hospitals, and we'll just focus on the hospital related side. That's your expertise. Give us an overview of the impact you are expecting in Northern California and central and your territory.

Lot of questions about people losing coverage. A lot of people losing federal incentives, rural hospitals, just losing a lot of backing. Give us a quick overview and then we'll dive in.

Yeah, unfortunately, there's not a lot of specifics except for there's gonna be massive change, there's gonna be a lot less money going towards healthcare than there was previously.

And in some cases Alameda Health is looking at, an annual impact of a hundred million dollars a year in lost revenue. You're looking in San Francisco. Grants and HHS grants and NIH grants and research upwards of a billion dollars a year being taken out in Santa Clara County.

You're also looking at a billion dollars being taken out. You're look at individual hospital systems like North Bay Health, they're looking at an impact a direct impact of anywhere from 15 to $30 million. So there's some significant dollars associated with that.

Legislative issues that they wanted to help offset the costs. And when you look at some of the biggest drivers of government spending, it is in healthcare, because we'd already talked about 80% of the people that are utilizing the healthcare system today are either on a Medicare or a Medicaid or some combination thereof, a plan.

And so that was the largest dollar amount and it there really was next to zero. Discussion on healthcare policy. It was really looking at how much was the cost that they could extract to be put towards other priorities. And the challenge now is we gotta figure out how that system is gonna be put together.

Because it was while the. Public policy on healthcare delivery really wasn't discussed and wasn't the impact is massive. And so now we are left, we hospitals, we as healthcare, we as public health, we as universities have to figure out how do we operate. With the much less funding than we had before.

And what are the coverage implications of that? We have a kind of a perfect storm of a crackdown on immigration. We've already seen the number of, of individuals with uncertain immigration status here in California, utilizing the healthcare system a lot less. That doesn't mean they're not gonna use it at some point in the future, but they're delaying care.

We've seen examples of during COVID and during the closure of other hospitals when you delay care, when they come back into the healthcare system, that care is much more acute, much more severe, much more costly. Everybody's trying to figure out what the actual implications are. And we're not getting a lot of direction right now from health and human services from CMS on the federal side 'cause they're trying to figure everything out.

The state's trying to figure everything out. And it's just a very challenging environment. Will I think really be at the forefront in 2026? I think the actual cuts to healthcare and the funding, we really won't see the most impactful things occur until a. Late 20 27, 20 28, because some of these cuts don't go into effect until some of the out years.

And there's some politics involved in that. we basically have maybe about 18 months to try to figure out how to navigate in these new financial waters and have a lot less resources to provide the care that people have been expecting.

So let me dive in to some stats that the California Hospital Association put out about that.

So 15 million of the close to 40 million Californians which is about 38% of the state are on Medi-Cal. That's the low income program. 30% reduction, pretty much across the board for that. What is the impact on that? You're talking it was already done at less service.

Is it just less people having insurance now or they cutting 30% off? Or do they make that up because they cut out care? Help us understand that.

. I think these are individuals that are gonna be losing coverage. So what happens there is hospitals are required from a federal perspective, is to provide care for anyone that shows up at the ED department.

And so regardless of their ability to pay. So that's why we have been seeing an a significant increase of individuals going to the ED for non-emergent. Issues. So ear aches sore throats, those things. And that really is the most expensive way to do any type of care.

Additionally, individuals that have chronic disease, whether it's, pulmonary disease, diabetes, oftentimes they show up at the emergency department for some symptoms related to that and not really you're, it is really difficult to manage their care through the ED department, and if they don't have coverage, they're not gonna see a primary care physician.

They're not gonna have a medical home. They're gonna delay care. And then when they do show up into the healthcare system, it's gonna be much more costly to treat. right now we have about a 3% to 4% uninsured rate here in California because we've covered everyone, at least through Medi-Cal. And through other payer systems such as private insurance some public insurance covered California.

Also with Medicare that could go up at 13, 14, 15%. What that means is individuals will still get care, but it'll be uncompensated care, and then that raises a cost for everybody. this is what everybody's trying to sort out now to figure out how many people are gonna delay care, how many people are not gonna access the system.

When they should be accessing the system. And the challenges that we're gonna have, I think will be immense. I do think we have a recent experience here in California to look at Madera Community Hospital closed. It was closed for almost three years and during the time it was closed, it also closed three rural healthcare clinics.

And what we saw. is you had individuals that couldn't access care to the next closest hospital. 'cause the next closest hospital was either in Southern Madera or in Fresno because they didn't have a car. We saw adults. Pass away in a pediatric hospital at Valley Children's because that was the closest hospital to Madera.

And so they would go for healthcare, adults would go for healthcare at the children's hospital, and then you saw. Double and triple digits of increase of utilization for hospitals in Fresno, of people traveling from Madera for various conditions, including maternity health O-B-G-Y-N services, mental, behavioral health, because those services weren't available in Madera, and so that was just one hospital and it took three once that hospital closed.

It took three years for that hospital to reopen. It's very difficult to reopen a hospital. And what we've seen here in California and what we've seen across the country is that I think elected officials think that as long as the hospital's open and the ed's open. Everything's great. But what they don't see is the death by a thousand cuts when you have service lines being cut, whether they're cardiac services, ob, GYN services, mental behavioral health services, those are all services that hospitals when they have to make difficult decisions in either to keep them operational or to find the employees.

To run those service lines, they close those service lines. And so while the hospital technically is open, the amount of care and the type of care gets pushed out to other areas and it makes it more difficult for people to access care. And so that's why we talk about access is such a critical component and we think that's gonna have some critical implications with this one big, beautiful bill.

You're talking 20 to 25% on average of users then have corporate insurance right. Through their employer. How are those people impacted by this? Because the hospitals have to make up the rate.

Wouldn't that. Dramatically increase the cost to those, or those are fixed costs, right? It's the insurance company says it's 500 bucks for this, and that's all the hospital gets.

We have a regulatory body that the state has recently created, called the Office of Healthcare Affordability, which looks at, the goals how do you keep healthcare affordable? It seems their laser target is on hospitals. When over the past five years or so, hospital costs have increased on average between three to 5%. And if you look at the target that they're looking at it's in that area.

Whereas insurance rates have increased by over 20%. And those are costs that companies pay, individuals pay. And I think as we get back to talking about how we develop a healthcare system is I know of no other commodity or service that people utilize on a regular basis and have no idea on how much that service or commodity actually costs.

Because for somebody like me that has insurance, I don't pay the full cost of my insurance. My employer pays part of that insurance. I pay part of that premium. I may have a copay or have a deductible but I don't know how much that cost, just like with the Affordable Care Act, there were certain essential health services that were identified that were quote, unquote free.

They were free for you. They were free for the user, but for the doctor or the hospital that was providing that service. Those aren't free. And so those costs have to be accounted for in some way. And so that's why the incentives are all misaligned. And it is a big challenge

When you have this amount of financial shifting going on and the amount of money that's being taken off the table by the state and federal government you're gonna see a combination of service line closures. you're gonna see hospitals close, you're going to see rates increase in certain areas.

And so it's gonna take a while for all that to play out. I think different individuals will have a different financial impact, but I think most importantly is the services that you look forward to today that may be accessible in your area may not be accessible in the future.

and then you have to travel a significant distance in order to access those services.

Will those cuts still happen in the Metro Bay area or, there's always another doctor I guess, if you could pay for it, right?

Yeah. And I think California is a microcosm of the entire country and so you have some areas that are gonna be greatly affected.

Some areas are gonna be less impacted, but all of them are gonna have some financial impact. I think in the Bay Area. when you take a billion dollars out of Santa Clara County and you take a billion dollars out of San Francisco and you take, hundreds of millions of dollars outta Contra Costa and Solano those all have significant impacts.

I think to think that you're gonna have the same type of services. The same access to services is a challenge. I think what you're seeing with the systems in the Bay Area and in the East Bay area is how do they, how can they efficiently and effectively provide those services. I think you're seeing a lot of investment in outpatient and ambulatory areas and making the hospital less of the central.

Area of where you get your primary care. And so I think you're seeing a lot of investment, whether you're Kaiser, whether you're Sutter, UCSF. Alameda Health, John Muir all of the North Bay, they're looking to how do we provide that care in communities and how do we do it in the most efficient, effective way?

And so I think that the delivery of care is gonna change

And I just want to throw numbers out. The hospital association in California says the impact of the state is somewhere between 66 billion and 128 billion cut in the next 10 years. that's a wide estimate.

'cause you said there still have rules to write, programs to figure out as this rolls out, which will change that fluctuation. But even if each county loses about a billion dollars locally, that's 10 billion in the region, right in the nine county area, maybe nine, 10, 10 billion.

That's significant. And that can't be made up in philanthropy, right? Sure. Philanthropy will close the gap, but not nine to 10 billion. And that will have A trickle down economic impact. And even more so in those rural areas you're talking about it will impact lunch places and people's take home pay and jobs will have to get cut out of those numbers as services change.

You've said you've done economic development. Just any thoughts on the overall budget too as those services change?

Yeah I think it's gonna be a challenge for everybody. It's gonna be a challenge for businesses. It's gonna be a challenge for the state taking that much money in a 10 year period of time.

So if you take a 10 year horizon it's gonna require literally transformational change in the healthcare. Environment and the healthcare delivery system. And the one thing that California is not set up to do on a state level and on a regulatory level is transformational change. And and to do it quickly.

And so hospitals are trying to figure out how do we operate within the regulatory framework. And then also being able to finance this. Ultimately, how do you provide the care to the patients that they're trying to serve day in and day out? And that's what's keeping everybody up at night.

Yeah, that's a lot going on. And it sounds like the bigger impact could be to these rural places that might not have other options.

Yeah, and I think if you have a hospital that is, hundreds of miles away, hours away from the next closest facility it's a different level.

They also don't have the economic base. as maybe businesses and hospitals in the East Bay or the Bay Area. That makes it very challenging. They just can't automatically find a bunch of dollars, find a lot of philanthropy. And at the same time, hospitals are still trying to upgrade on Seismic.

And some of our hospitals that haven't upgraded to seismic yet are in these rural communities just because they don't have. The millions of dollars necessary to. Update their facilities to the current regulations. All of them have met the 2020 standards. And basically that means the hospital's not gonna collapse during a major quake.

And what 2030 requires hospitals to do is remain fully operational after a major quake. And that, that is significant dollars. All privately financed, all has to be either raised by the hospitals themselves. There's no government funding associated with that. And all of these financial pressures are just exacerbated by now.

The one big, beautiful bill there were immense before and now they're they're daunting.

let's talk about ai. In healthcare. AI is a big topic. Just in the news, in the headlines. We've talked about it from lots of different angles here. What what are you seeing, how are hospitals changing and embracing ai?

And can some of that help reduce cost or allow staff to be allocated towards other resources?

So the short answer is yes. There's also a concern is like, is AI gonna replace jobs? We had an AI conference last year with a lot of the hospitals from the Bay Area, from the East Bay.

So we had UCSF, we had UC San Diego, we had uc, Davis. We had Stanford. All talking about AI and healthcare and basically the consensus was, is that it's not gonna eliminate jobs, but it will eliminate jobs for people that don't know how to utilize ai. You're gonna have to figure out how to incorporate ai.

I just saw something in Becker's today where I think it was UCSF now has over 200 plus AI products. They're utilizing in the diagnostic and in the administrative area I know insurance companies and payers on the admin side are utilizing ai. That's good. And it's also presents some challenges on making sure that.

There's some human oversight on that, but I don't think the healthcare system is gonna be taken over by ai. I think it's going to be enhanced by ai. We're lucky to be in the Silicon Valley area and have access to this and working with these companies. But it is gonna be a critical component moving forward in the future. It's something that I know our rural hospitals are already utilizing because it helps them out. It gets access to care for individuals that used to have to travel. Far distances. Telehealth, I would say would be like the infancy of ai.

And now you can look at you can get consults, you can get second opinions with ai, I know from a payer standpoint, both with the federal government level and in the private insurance area, you have ai. Helping process claims which is good. But then you also have to be cognizant that prior authorizations or denial of claims aren't done automatically.

there's some oversight on that. So it, once again, I think it's another area where we're learning. To build the plane as we're flying it. it's a really challenging regulatory environment, but it's good. There's some areas where doctors have found some of the transcription services.

So when they're meeting with patients, instead of them huddled over a keyboard and having to type everything in, they now have notes that transcribe the conversation with the patients. Doctors feel more connected with the patients. The patients feel more connected with the doctors. That has been something that's been very positive.

Some of those can get automatically uploaded into the medical record. Some of those can even be coded for payment. But the challenge is. How do you back check that? How do you make sure that there's accuracy there?

I have a police tech company like that, and we're, what we say is the officers are still responsible for reading it and signing their name to it,

Because the systems only pick up. Like they might not pick up what you saw over here on the side. That's important. Before we leave, any further thoughts that you wanna leave the audience with from an impact of changes coming in healthcare or on policy or both real quick?

I think to your listeners out there be aware of what's going on with healthcare.

If you are having challenges with the healthcare system, don't let your doctor know, or your caregiver or your system know, but let your elected officials know. Those personal stories do matter. And these are elected officials at all levels of government. In California, a lot of healthcare goes through the county level, especially mental and behavioral health.

Public health testing. Please let your Board of supervisors know. Keep them aware. I know we've been briefing them on the Office of Healthcare Affordability. Please let your state representatives, your state assembly members, your state senators and then your members of Congress also know it's really critically important.

And this isn't something that we'll figure out in the next. 30 days. 30 months or even three years. This is something that we're gonna have to stay diligent on and the healthcare system that we have today is definitely gonna be different than the healthcare system we have starting next year.

Brian Buckle, thank you for joining us from the Northern and Central California hospital Council.