H1 has raised over $200m to build out a very comprehensive data set of physicians internationally. Those products were primarily aimed at pharma. Now they are moving into the world of managing physician data for plans and providers, primarily via the 2025 acquisitions of Ribbon Health and Veda Health. I spoke with CEO Ariel Katz,…
Several insurers, such as UnitedHealthcare, Aetna and Cigna, pledged to improve prior authorization. These changes include streamlining decision timelines and increasing transparency. The post More Than 50 Health Plans Commit to Simplifying Prior Authorization appeared first on MedCity News.
At the HFMA Annual Conference, AI expert Zack Kass shared a personal story to emphasize the enduring importance of human qualities like empathy and compassion in healthcare. In his view, these qualities will only become more essential as AI continues to transform the clinical landscape. The post Why This Former OpenAI Exec Is Urging Health…
Kim Beckham, agente de seguros en Victoria, Texas, había visto a sus amigos sufrir tanto por la culebrilla (shingles) que quería recibir la primera vacuna aprobada contra esta infección tan pronto como estuviera disponible, incluso si tenía que pagarla de su bolsillo. Su médico y varias farmacias le dijeron que no podían administrarle la vacuna…
In Phase 1/2 results for 12 patients at least one year after receiving the cell therapy, zimislecel, Vertex Pharmaceuticals reported all participants achieved blood glucose in the target range and 10 of the 12 were free of exogenous insulin as of the data cutoff. Vertex expects to complete enrollment in the pivotal portion of the…
That is the title of my paper out today in the Journal of Comparative Effectiveness Research written with co-authors Adam Kittai, Dipen Patel, Nadine Zawadzki, Vikram Shetty, Yazan Barqawi, and Joanna Rhodes. The abstract is below. Aim: To estimate cost savings associated with covalent Bruton’s tyrosine kinase inhibitor (cBTKi) choice in patients with treatment-naive (TN) and…
People with low incomes and limited financial resources can qualify for the Medicare Savings Programs, through which state Medicaid programs provide financial assistance with Medicare premiums and cost sharing. However, provisions in the GOP’s budget reconciliation bill would make it harder for people to enroll in these programs. Many people with Medicare are facing a…
This brief looks at changes to Marketplace plans recently finalized by the Centers for Medicare and Medicaid Services (CMS) that may incentivize insurers to make their plans less generous. With less generous plans, consumers could face higher out-of-pocket costs, though those who don’t qualify for premium tax credits could see lower premiums.
This brief describes key challenges that Medicaid work requirements may pose for adults with mental health or substance use disorders. In May, the House passed a budget reconciliation bill that includes national Medicaid work requirements for adults in the Affordable Care Act (ACA) expansion group.
This policy watch discusses the data privacy protections in Medicaid and the implications of breaches or violations of those protections.