Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right
CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They’re designing…
CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They’re designing utilization management systems that are clinically sound, operationally efficient, and aligned with enterprise goals. The post Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right appeared first on MedCity News.
Fragmented finance systems have long caused operational challenges. By addressing this, CFOs can optimize and streamline many finance processes to improve compliance readiness and create time for business-driven decisions that support business objectives. The post Addressing Operational Inefficiencies in Healthcare Finance to Drive Better Business Decisions appeared first on MedCity News.
Un fin de semana de fines de abril, Leah Kovitch estaba arrancando plantas invasoras en un prado cerca de su casa cuando una garrapata se le prendió en la pierna. No notó al diminuto insecto hasta el lunes, cuando empezó a sentir dolor en el músculo de la pantorrilla. Esa misma mañana, hizo una cita…
The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.
The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.
As misinformation about women’s health spreads faster than ever, doctors say new research on the risks of hormonal birth control underscores the challenge of communicating nuance in the social media age. The massive study, which was conducted in Sweden and tracked more than 2 million teenage girls and women under age 50 for more than…
Leah Kovitch was pulling invasive plants in the meadow near her home one weekend in late April when a tick latched onto her leg. She didn’t notice the tiny bug until Monday, when her calf muscle began to feel sore. She made an appointment that morning with a telehealth doctor — one recommended by her…
This report, based on a KFF/New York Times survey from fall 2025, provides data on health and health care experiences of immigrant adults ages 18 and over in the current policy environment. Four in ten immigrant adults overall and nearly eight in ten likely undocumented immigrants say they have experienced negative health impacts due to…
Most immigrant voters disapprove of President Trump’s handling of immigration, including large majorities who disapprove of policies like “third country” deportations and efforts to end birthright citizenship. These views may have implications for future elections, as six in ten immigrant voters say the administration’s immigration enforcement actions have had an impact on which political party…
A new KFF/New York Times Survey of Immigrants reveals deepening anxiety and fear among immigrants of all statuses amid the Trump administration’s intensified immigration enforcement and restrictive policies. Findings from the new survey are detailed in three KFF reports and help inform the reporting in a package of news stories by Times reporters.