The ‘Bot Vs. Bot’ Dynamic Between Providers & Payers Is Driving Up Costs for Everyone
HSS chief digital and information officer Ashis Barad, who has worked on both the payer…
The ‘Bot Vs. Bot’ Dynamic Between Providers & Payers Is Driving Up Costs for Everyone
HSS chief digital and information officer Ashis Barad, who has worked on both the payer and provider sides of healthcare AI, thinks the industry’s growing “bot vs. bot” battle over prior authorizations and appeals is driving costs up. To him, the real fix lies in providers and payers sharing data to build more personalized care…
GSK Drug From $2B Deal Sputters in Phase 3 Test in Chronic Cough
GSK said the mixed Phase 3 results for camlipixant mean this pill “is unlikely to transform patient care” in recurrent chronic cough. GSK is stopping work in this indication, a setback to a program once hoped to yield a new blockbuster product for the company’s respiratory drug portfolio. The post GSK Drug From $2B Deal…
Why Specialty-Specific Measurement and Intervention Are Essential to Address Healthcare Burnout
The opportunity ahead is to treat physician well-being as a core strategic priority, measured with the same rigor and acted upon with the same urgency as any other critical performance domain. The post Why Specialty-Specific Measurement and Intervention Are Essential to Address Healthcare Burnout appeared first on MedCity News.
Why Settle for Acceptable Versus Optimal Outcomes?
New 3D printed technology makes lower extremity surgeons architects of restoration, not adaptation. The post Why Settle for Acceptable Versus Optimal Outcomes? appeared first on MedCity News.
Watch: ‘Robust’ Primary Care, Transparency Top Employers’ Reform Wish List
In this “How Would You Fix It?” interview, Julie Rovner, KFF Health News’ chief Washington correspondent and host of the What the Health? podcast, sat down with Elizabeth Mitchell, the president and CEO of the Purchaser Business Group on Health, which represents many large employers and other institutional buyers of healthcare coverage. Mitchell noted that…
Insurers Hedge on Trump-Backed Pledge To Improve Denials Process
One year after the Trump administration announced that dozens of health insurers had signed a six-part pledge promising to reduce barriers to doctor-recommended care, some insurers now say they won’t implement all the promised initiatives. Meanwhile, patients, their advocates, and clinicians say little has improved. “It has never been this bad for patients,” said U.S….
Healthcare Groups Praise Unanimous Committee Approval of MA Prior Auth Bill
The House Ways and Means Committee unanimously advanced a bill to reform Medicare Advantage prior authorization requirements. The post Healthcare Groups Praise Unanimous Committee Approval of MA Prior Auth Bill appeared first on MedCity News.
Why CMS Is Trying to Ban Third-Party Remote Patient Monitoring
CMS’ proposed 2027 Physician Fee Schedule would bar Medicare payment for remote monitoring services delivered by third-party vendors, following OIG reports that flagged widespread fraud in the space. The post Why CMS Is Trying to Ban Third-Party Remote Patient Monitoring appeared first on MedCity News.
Trump’s CDC Nominee Praises Vaccines, Without Vowing Independence From Kennedy
Erica Schwartz, President Donald Trump’s nominee to lead the Centers for Disease Control and Prevention, expressed support for vaccines — including mRNA-based covid shots — in a Senate hearing on Wednesday, though she didn’t dispel concerns the agency has lost any independence from the White House. “I have been vaccinating people throughout my entire career…
Why Do We Hear More About High Drug Prices Than About Hospital Prices?
In this JAMA Health Forum post, KFF’s Larry Levitt outlines four reasons why high drug prices are in the spotlight more than hospital prices, even though hospitals accounted for 40% of the growth in national health spending from 2022 to 2024, and explores the potential for policy action to restrain them.
