CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization…
CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers. The post CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation appeared first on MedCity News.
Two Imperatives for the Future of Diagnostics: Adaptability and Digitalization to Unlock the Potential of AI
While this kind of innovation and change can be challenging and is often a significant investment, it represents a powerful combination that can benefit individuals, healthcare professionals, and laboratories. The post Two Imperatives for the Future of Diagnostics: Adaptability and Digitalization to Unlock the Potential of AI appeared first on MedCity News.
Health Wildcatters Launches HW Venture Center to Foster Investor-Startup Matchmaking
Fourteen investors have committed to offering office hours at the HW Venture Center in July and August. The post Health Wildcatters Launches HW Venture Center to Foster Investor-Startup Matchmaking appeared first on MedCity News.
Los Angeles Weighs a Disaster Registry. Disability Advocates Warn Against False Assurances.
In the wake of January’s deadly wildfires, Los Angeles County leaders are weighing a disaster registry intended to help disabled and senior residents get connected to emergency responders to bring them to safety during disasters. County supervisors approved a feasibility study this spring for such a voluntary database. Supporters applauded the effort to give more…
Maybe It’s Not Just Aging. Maybe It’s Anemia.
Gary Sergott felt weary all the time. “I’d get tired, short of breath, a sort of malaise,” he said. He was cold even on warm days and looked pale with dark circles under his eyes. His malady was not mysterious. As a retired nurse anesthetist, Sergott knew he had anemia, a deficiency of red blood…
Why Multi-morbidity Requires Two Health Systems, not One
By JEREMY SHANE What’s behind the coming health care reckoning? Most industry leaders have their preferred list of culprits: not us! Left-leaning critics blame large insurers, drug companies, and private equity firms. Take the profit and self-dealing out of health care. Those on the right blame excessive regulation, poorly-designed insurance markets, or limits on individuals’…
CalPERS Selects CVS Caremark as PBM, Replacing OptumRx
CalPERS has entered into a five-year agreement with CVS Caremark, who will provide outpatient prescription drug benefits for about 587,000 members enrolled in basic or Medicare HMO or PPO plans. The post CalPERS Selects CVS Caremark as PBM, Replacing OptumRx appeared first on MedCity News.
How Does the Federal Government Monitor Vaccine Safety?
This issue brief gives an overview of the main systems used by the federal government to track vaccine safety and adverse events following vaccinations. The brief reviews the history of federal vaccine safety systems, describes the key systems and their strengths and limitations, and also discusses how vaccine safety issues have become the subject of…
A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law
The new reconciliation law includes a $50 billion rural health fund. This brief describes the rural health fund, explains what the law says about the allocation of funds, and highlights outstanding questions about how the funds will be distributed across and within states to pay rural hospitals and for other purposes.
Despite Progress, Healthcare Cybersecurity Is Still Falling Short
Healthcare providers are making cybersecurity progress, but serious vulnerabilities remain — especially when it comes to AI governance, third-party risk, and limited budgets. Fortified Health Security CEO Dan Dodson urged the industry to stop waiting for perfect conditions and act decisively to strengthen their defenses. The post Despite Progress, Healthcare Cybersecurity Is Still Falling Short…
