Prior Authorization is a Fight and AI Won’t End It — Stop Pretending Otherwise
The honest question is not whether AI will end the fight. It will not. The…
Prior Authorization is a Fight and AI Won’t End It — Stop Pretending Otherwise
The honest question is not whether AI will end the fight. It will not. The honest question is what AI does to a fight that has been structurally imbalanced for 30 years. The post Prior Authorization is a Fight and AI Won’t End It — Stop Pretending Otherwise appeared first on MedCity News.
Medicaid’s Next Performance Test: Can Plans Reach the Members They’re Accountable For?
For many of Medicaid’s highest-need members, the problem isn’t that services don’t exist. It’s that the system can’t consistently reach the people who need those services most. The post Medicaid’s Next Performance Test: Can Plans Reach the Members They’re Accountable For? appeared first on MedCity News.
Stop the Revolving Door: Why Five-Year Contracts are the Key to Saving Medicare Advantage
To truly deliver on the promise of proactive, preventive care for seniors with complex, chronic conditions, we should move away from the current one-year open enrollment cycle and toward a five-year contract period. The post Stop the Revolving Door: Why Five-Year Contracts are the Key to Saving Medicare Advantage appeared first on MedCity News.
Journalists Discuss Raw-Milk Marketing, Extreme Heat, Opioid Settlement Spending
Céline Gounder, KFF Health News’ editor-at-large for public health, discussed the health risks of consuming raw milk and an outbreak of infant botulism linked to recalled formula on CBS News’ CBS Mornings and CBS News 24/7’s The Daily Report on July 7. Gounder also discussed allegations about Health and Human Services Secretary Robert F. Kennedy…
Handspring Snags $19M to Fix the “Missing Middle” of Youth Mental Health Care
Handspring raised $19 million in Series B funding this week to expand its pediatric mental health care model nationwide. The company treats the full spectrum of acuity so children are matched to the level of care they actually need, rather than defaulting to the most intensive — and expensive — option available. The post Handspring…
UHC Unveils New Employer-Sponsored Spending Account Benefit
UnitedHealthcare introduced a Lifestyle Spending Account that gives employers more flexibility to fund employees’ health and wellness expenses. The post UHC Unveils New Employer-Sponsored Spending Account Benefit appeared first on MedCity News.
Glaucoma Drug Fails Trial, But Bausch + Lomb Sees Opportunity in Another Eye Disease
A Bausch + Lomb drug from a 2025 acquisition missed primary and secondary goals of a Phase 2 test in glaucoma. Bausch now plans to develop this drug for geographic atrophy, aiming to succeed where Allergan, now an AbbVie subsidiary, fell short in the clinic. The post Glaucoma Drug Fails Trial, But Bausch + Lomb…
In Performance Year 2024, REACH ACOs Generated $2.5 Billion in Savings
Despite ongoing improvement, stakeholders highlight need to modernize how accountable care models are evaluated
How AI Can Support Better Mental Health Outcomes — With Humans at the Center
Mental health care does not need to become less human to become more effective. The most effective (and responsible) path forward is one built on partnership The post How AI Can Support Better Mental Health Outcomes — With Humans at the Center appeared first on MedCity News.
Why Most Healthcare Brand Strategies Fail the First Time Leadership Gets Tested
If you are sitting on a brand strategy right now, the test is not whether your team likes it. The test is whether it can be defended by someone who did not build it, to a board that did not commission it, by a leader who did not hire you. The post Why Most Healthcare…
