[Sponsored] In this episode, MedCity News’ Arundhati Parmar chats with a pharmacy benefits leader and a virtual pharmacy operator about ways to modernize and scale prior authorization. The post MedCity Pivot Podcast: Modernizing Prior Auth appeared first on MedCity News.
The question is no longer whether shareback matters. It is whether the healthcare ecosystem is willing to prioritize it in practice by recognizing it in policy measurement, monitoring, and enforcement, as well as investing in the technical and governance structures needed to make shareback routine, high-quality, measurable, and reportable. The post Why Quality Shareback is…
Healthcare has solved for the hard part. The science, the surgery, the diagnosis: by global standards, we’re exceptional. What we haven’t solved for is what happens when the patient goes home. The post The Healthcare Industry Has a Last Mile Problem — It Hasn’t Realized It Yet appeared first on MedCity News.
At the Medicarians Conference, Ricardo Carcas, assistant special agent in charge of the Office of Investigations, discussed cases of fraud in the ACA and how the DOJ is combatting it. The post How the DOJ Is Tackling Fraud in the ACA Marketplace appeared first on MedCity News.
Merck’s HIV drug Idvynso could become a drug choice for patients who need to switch from Gilead Sciences’ Biktarvy for safety or tolerability reasons. The Merck combination drug pairs two molecules that bring different mechanisms of action to suppressing HIV. The post FDA Nod for Merck HIV Drug Brings Competition to a Gilead Sciences Antiretroviral…
The challenge is determining whether wearable data is reliable enough to relieve the review burden, guide care, support reimbursement, or reassure a patient who is worried about their heart rhythm at two o’clock in the morning. The post Wearable Noise Is Exploding — Trust Is the Filter appeared first on MedCity News.
Healthcare interoperability isn’t an abstract concept; it’s about human connection, building trust and easing burden on patients and their care providers. The post Trust, Technology and the Future of Interoperability: Solving Problems That Impact Real Lives appeared first on MedCity News.
At the annual Medicarians conference in Las Vegas that draws brokers, agents, agency owners and field marketing organizations, among others, Dawn Maroney suggested that payers are not always the “bad guys.” The post Alignment Health Plan CEO: Sometimes When MA Plan is Pulling Out, the Provider is to Blame appeared first on MedCity News.
Oscar Health launched Lucie, a marketplace aimed at making healthcare more shoppable. The post Oscar Health Seeks to Build ‘Airbnb for Healthcare’ with New Marketplace, CEO Says appeared first on MedCity News.
Tortugas Neurosciences’ two lead programs are in-licensed oral small molecules in development for schizophrenia and tinnitus. The startup is led by veterans of Sage Therapeutics, a neuroscience biotech that was acquired last year. The post Neuro Startup Tortugas Unveils $106M and a Pipeline of Drugs for the Brain appeared first on MedCity News.