More than three years ago, health insurance giant Centene Corp. settled allegations that it overcharged Medicaid programs in Ohio and Mississippi related to prescription drug billing. Now at least 20 states have settled with Centene over its pharmacy benefit manager operation that coordinated the medications for Medicaid patients. Arizona was among the most recent to…
Digital health engagement app Wellth raised $36 million in Series C funding to expand its “daily care motivation platform,” which uses small financial incentives and dopamine-driven nudges to keep patients engaged in healthy behaviors. The post Could Small Cash Prizes Motivate People to Be Healthier? Investors Say Yes appeared first on MedCity News.
To document the affordability challenges posed by out-of-pocket health care costs for people with Medicare, this brief analyzes out-of-pocket health care costs as a share of Social Security income and total income, including other sources of income in addition to Social Security.
As hospitals face ongoing cost pressures and supply chain disruptions, Allina Health is redesigning its procurement strategy by moving away from a decentralized sourcing model and toward an approach that prioritizes governance and tech-driven efficiencies. Chief Supply Chain Officer Tom Lubotsky shared how the health system is saving money and boosting supply chain resilience. The…
CHARLESTON, S.C. — When Page Campbell’s doctor recommended she try an injectable prescription drug called Wegovy to lose weight before scheduling bariatric surgery, she readily agreed. “I’ve struggled with my weight for so long,” said Campbell, 40, a single mother of two. “I’m not opposed to trying anything.” In early April, about four weeks after…
This brief examines current Medicaid eligibility policies and enrollment patterns using data from KFF’s 2024 50-state survey of states’ eligibility and enrollment policies for seniors and people with disabilities, and 2021 Medicare and Medicaid claims data from the Centers for Medicare and Medicaid Services (CMS).
AI can be a highly effective tool for plans aiming to reduce fraud, waste and abuse, but only if it is combined with investigative intelligence. The post AI: A Good Tool to Combat Bad Actors in Healthcare appeared first on MedCity News.
A new WTW survey reveals that over half of employers exceeded their healthcare budgets in 2024 and expect rising costs to continue, prompting a shift toward cost-containment strategies, vendor accountability, AI adoption and alternative plan designs. The post WTW: Half of Employers Exceeded Their Healthcare Budgets in 2024 appeared first on MedCity News.
Industry experts discuss cybersecurity within healthcare organizations at the annual HIMSS conference
Penguin Ai raised $29.7 million for its AI platform aimed at automating costly administrative tasks like prior authorization and medical coding. CEO Fawad Butt said the startup’s goal is to move beyond point solutions and create an “Epic of the healthcare back office.” The post Penguin Ai Snags $30M to Simplify Prior Auth, Coding and…