Just over 35 million people are enrolled in Medicare Advantage in February 2026, an increase of 1.1 million since a year ago. The increase was largely driven by increased enrollment in special needs plans.
[Sponsored] Measurement-based care (MBC) has shifted from a best practice to a baseline expectation in behavioral health and integrated settings. The post Designing Scalable Measurement-Based Care Systems for Expanding Health Care Organizations appeared first on MedCity News.
Después de un año agotador de quimioterapia, cirugía y radiación para tratar un cáncer de mama, Sadia Zapp se sentía ansiosa. No era la inquietud manejable que había sido parte de su vida durante años, sino algo más profundo y difícil de ignorar. Dijo que “cada pequeña molestia, como un dolor de rodilla, le hacía…
Backed by Abundant Venture Partners, company focuses the power of AI on helping health systems prevent overpayments on purchased services
Technology alone won’t solve prior authorization. But refusing to adopt it guarantees the status quo: a system where insurers operate at machine speed, providers operate at human speed, and patients pay the price in delayed care. The post Prior Authorization Is Broken. CMS’s New Rule Shows Why Regulated AI Is the Way Out appeared first…
Companies can avoid this trap by treating future growth as a foundation, not a later stage. Decision makers need to work backwards from scale, building software architecture and commercial architecture together. This shift alone helps teams make smarter choices within the first 90 days of a product’s launch. The post Why HealthTech Products Fail Clinical…
This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the…
After a grueling year of chemotherapy, surgery, and radiation to treat breast cancer, Sadia Zapp was anxious — not the manageable hum that had long been part of her life, but something deeper, more distracting. “Every little ache, like my knee hurts,” she said, made her worry that “this is the end of the road…
When Lisa Bonfield gave birth to daughter Adele in late November, she was thrust into the new world of parenting, and faced an onslaught of challenges and skills to learn: breastfeeding, diapering, sleep routines, colic, crying, and all the little warning signs that something could be wrong with the baby. But unlike parents in most…
¿Cómo deben usar la inteligencia artificial (IA) las aseguradoras de salud? La respuesta a esta pregunta inusual de política pública, encuentra en un mismo bando al gobernador republicano Ron DeSantis, de Florida, y al gobierno demócrata de Maryland, los dos contra el presidente Donald Trump y el gobernador de California, Gavin Newsom. La regulación de…