It’s tragic that it takes a shooter, aggravated by his back pain and frustrated with the healthcare system, to spark a necessary conversation about healthcare. The post Zero-Sum Game: The Current Healthcare System Is Reaching a Breaking Point appeared first on MedCity News.
[Sponsored] In this episode, a pharmacy benefit management executive and a pharmacy startup talk about why benefit verification, prior authorizations, and patient affordability still break the workflow and how smart integrations, real-time eligibility, and intuitive design can reduce friction for all involved. The post MedCity Pivot Podcast: Price Transparency is the New North in the…
Now, with the ability to measure coronary inflammation through AI-enhanced CT scans and to more accurately determine a person’s risk of heart attack, we can intervene earlier and more effectively. The post Regulatory Shift Paves Way for AI-Driven Heart Disease Diagnosis appeared first on MedCity News.
I got the very sad news today that Ian Morrison died peacefully at home yesterday. He had been sick and in hospice for some time but a few months back he told me that he was going for Jimmy Carter’s record. Ian was my first boss in American health care when I worked for him…
[Sponsored] Philips ventilators are known for their reliability, patient comfort and advanced monitoring features, but access depends on choosing the right rental partner. The post 6 Places You Can Rent a Philips Ventilator appeared first on MedCity News.
Yasir Tarabichi, M.D., chief health AI officer at MetroHealth, shares his perspectives
“Reducing denials upfront would improve our revenue, which could be channeled into current and future investments that support our mission.” —Joshua Gayman, Revenue Cycle Manager at UT Medical Center Challenge The University of Tennessee Medical Center (UT Medical Center) is a leading 710-bed acute care hospital with a rich history of exceptional patient care and…
Nearly 50 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2023, of which 3.2 million (6.4%) were denied. Just 11.7% of denied requests were appealed, though 81.7% of appeals overturned the initial denial in Medicare Advantage. Substantially fewer prior authorization requests were made in traditional Medicare,…
This approach positions senior healthcare leaders to not just manage costs effectively but transform AI from a cost center into a powerful strategic advantage. The post Unlocking Strategic Elasticity: A Healthcare Executive’s Guide to High-Efficiency Lean AI appeared first on MedCity News.
CMS’ new ACCESS model, slated to begin on July 1, aims to shift traditional Medicare fee-for-service toward value-based care by tying payments to patient outcomes and encouraging tech-enabled, preventive care. Experts say it could benefit digitally mature, value-focused providers first, but its overall success will hinge on clear metrics, better data sharing and sustained participation….