Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers. The post CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation appeared first on MedCity News.
That is the title of an interesting panel from USC Schaeffer Center on Coverage with Evidence Development (CED). It includes an interview with Tamara Syrek Jensen, Director, of the Coverage & Analysis Group within the Centers for Medicare & Medicaid Services. After the interview, there is a panel discussion with Darius Lakdawalla of USC, Peter…
Medical billing errors are common problems that can lead to significant financial losses for healthcare organizations. While most medical billing errors are preventable, outdated systems, complex processes and human errors often result in delayed or denied claims. Faced with ever-increasing overhead costs, workforce challenges and growing volumes of data, healthcare leaders will need to implement…
Intercept Pharmaceuticals is voluntarily withdrawing from the market Ocaliva, a drug for the rare liver disease primary biliary cholangitis. While Ocaliva became an important new treatment option when it won accelerated FDA approval in 2016, PBC patients now have new FDA-approved medicines from Ipsen and Gilead Sciences that don’t pose the same safety risks. The…
[Sponsored] If you’ve been researching current high-paying jobs in trauma centers or wondering which agencies have the best-paying contracts right now, you’re already thinking like a strategic travel nurse. The post Top-Paying Healthcare Settings for Travel Nurses and How to Land Them appeared first on MedCity News.
As margins tighten, traditional revenue cycle management strategies are on shaky ground. Many healthcare providers are turning to automation and AI to simplify payments, prevent revenue loss and protect profits. This article breaks down some of the most common revenue cycle management (RCM) challenges facing healthcare leaders and offers a practical checklist to optimize patient…
In a crowded healthcare AI market, the winners will be those that control key leverage points — where data is created, workflows are streamlined and value is delivered across stakeholders. This will differentiate winning AI startups from incumbents and copycat competitors, said Morgan Cheatham, head of healthcare and life sciences at Breyer Capital. The post…
Eli Lilly made good on its threat to withhold 340B drug discounts from hospitals that refused to submit claims data. Hospital groups are calling the policy unlawful, arguing that the company has no legal authority to create its own compliance requirements for a federal program. The post Hospitals Cry Foul After Eli Lilly Withholds 340B…
The biotech IPOs window is now open, but that doesn’t mean every company can go through it. A panel at the BIO Convention in San Diego discussed the steps biotech companies should take if they’re considering a public listing. The post The Things to Think About Before Taking Your Biotech Company Public appeared first on…
Regeneron Pharmaceuticals’ Otarmeni is now approved for treating hearing loss from an ultra-rare genetic mutation found in an estimated 50 newborns per year. While Regeneron will offer this gene therapy for free, the approval came with a rare pediatric disease priority review voucher that the company can sell for hundreds of millions of dollars. The…