Many health plans are discovering that even after digitizing medical policies and implementing FHIR APIs, prior authorization turnaround times remain slow and provider frustration remains high. The reason is straightforward: digitization alone does not make medical‑necessity determinations executable by automated systems at scale. The post Digitizing Medical Policy Alone Will Not Automate Prior Authorization at…
This is forcing brokers to rethink how they serve clients and how their businesses continue to grow without sacrificing service. The post As Health Costs Hit Record Highs, Brokers Face a Structural Test appeared first on MedCity News.
Nvidia and Hoppr are betting that healthcare AI will scale not through standalone applications, but through a new infrastructure layer that lets providers develop and deploy their own imaging models. The post Why Healthcare AI Still Can’t Scale — and How Nvidia & Hoppr Are Trying to Fix It appeared first on MedCity News.
Ed Park is sincere and passionate about his calling as the CEO of Devoted Health, which provides Medicare Advantage plans to seniors in 29 states. But it remains to be seen if he can do more or the same with less. The post CEO of For-Profit MA Plan Tells CMS “Pay Us Less” appeared first…
Timely by DrFirst launched a tool to streamline prior authorizations and improve access to specialty medications. The post Timely by DrFirst Aims to Lower Barriers to Specialty Meds appeared first on MedCity News.
Intellia Therapeutics’ lonvo-z uses CRISPR to inactivate a gene in the liver to reduce levels of a protein key to the swelling attacks from the rare disease hereditary angioedema. Intellia has filed a regulatory submission for this genetic medicine, which could become the first in vivo gene-editing therapy to land FDA approval. The post Intellia’s…
In dental practices, where reimbursement cycles are tighter and administrative inefficiencies are immediately visible, AI is already being evaluated not for novelty, but for operational impact. The post What Dentistry Is Teaching Healthcare About Operational AI appeared first on MedCity News.
The evolution of patient-matched medical devices represents more than just innovation in manufacturing and design. It marks a shift in clinical philosophy. Instead of shaping patients to fit implants, clinicians and device developers are harnessing technology to shape treatments around the individual. The post How Recent Changes in ‘Patient-Matched’ Technology Are Reshaping the Future of…
The phenomenon of taking five or more medicines at the same time has become so common that it now has its own term – polypharmacy – and there is no doubt that it increases the risk of dizziness, confusion, and loss of balance. The post Too Many Prescriptions, Too Many Fatal Falls appeared first on…
As patients take to social media, in all its ungated glory and promotion of misinformation, how can they be certain that what they are getting is accurate? What voices can they trust? The post Patients are Turning to HCP Influencers in the Age of AI and Misinformation appeared first on MedCity News.