Flipping the script on payer denials and downcoding
Tired of skyrocketing payer denials? Here is how medical practices can finally fight back with AI.
The automated practice: A survival strategy for independent healthcare
Why automation is becoming essential for independent practice survival.
Behind the outcomes: How whole-patient support is reshaping oncology care
As oncology care grows personalized and home-based, support around treatment becomes as vital as treatment.
Strikes boil at Mass General Brigham, Mount Nittany
About 4,500 workers at Mass General Brigham are striking this week, while employees at Mount Nittany Medical Center in Pennsylvania said they would take to the picket line later this month.
CVS CEO says Aetna has a handle on medical costs in advance of Q2 earnings
David Joyner’s assurances, which come about a month before CVS is scheduled to report its second quarter results, will likely be welcomed by investors wary after a difficult few years for insurers.
Resmed to sell software business MatrixCare to private equity firm
Selling the unit, which provides an EHR for post-acute care, will allow the respiratory device maker to shift more resources to faster-growing parts of its portfolio.
Whistleblower lawsuit accuses Alignment of accounting fraud
A former executive is claiming that the MA insurer recorded millions of dollars as capital expenditures that should have been operating expenses, inflating its value. Alignment strongly denied the allegations.
Centene exits Arkansas Medicaid expansion program, citing funding challenges
ARHOME represents a small portion of Centene’s overall membership and premiums. But the exit represents how insurers are rejigging their businesses in advance of Medicaid work requirements, one analyst said.
Physicians’ wearable data use hampered by reimbursement, workflow barriers: survey
“We have all this data that’s available, but it’s actually not actionable because we don’t have a way to get it into clinical workflow,” said American Medical Associaion CEO Dr. John Whyte.
ACA premiums set to spike again in 2027
Insurers are proposing a median premium increase of 14% for 2027, according to KFF, suggesting another year of double-digit premium hikes as policy upheaval and rising costs continue to roil the marketplaces.