Five Key Facts About Spending and Enrollment for People with Medicare and Medicaid (Dual-Eligible Individuals)
This issue brief analyzes provides a profile of enrollment and spending on dual-eligible individuals, drawing…
Five Key Facts About Spending and Enrollment for People with Medicare and Medicaid (Dual-Eligible Individuals)
This issue brief analyzes provides a profile of enrollment and spending on dual-eligible individuals, drawing on new analysis of data on chronic conditions to show how higher rates of chronic conditions contribute to higher average spending among this population.
Answers at the Speed of Thought: Healthcare Analytics in the Era of Agentic AI
We are moving into an era where we can finally converse with our data. We can ask, “Why are denials spiking in Region X?” or “Show me the safety profile of this cohort,” and receive an answer, not a spreadsheet. The post Answers at the Speed of Thought: Healthcare Analytics in the Era of Agentic…
The Measurement Problem Behind Two Decades of Neurology Trial Failures
The FDA now treats continuous, real-time data sharing as a regulatory direction of travel rather than a theoretical future. The neurology field should pay close attention. The post The Measurement Problem Behind Two Decades of Neurology Trial Failures appeared first on MedCity News.
Off the Radar: How Unapproved AI Is Complicating Healthcare Cyber Risk
You cannot secure what you cannot see, and right now, healthcare organizations are accumulating hidden cyber liabilities with every keystroke. The post Off the Radar: How Unapproved AI Is Complicating Healthcare Cyber Risk appeared first on MedCity News.
Payers Who Improve Data Quality Will Define the Next Era of Health Plan Performance
[Sponsored] On July 22, a webinar sponsored by Verato will spotlight perspectives of executives from Scan Health Plan and the Alliance of Community Health Plans. The post Payers Who Improve Data Quality Will Define the Next Era of Health Plan Performance appeared first on MedCity News.
Facing Funding Losses, States Call Out Big Businesses With Employees on Medicaid
As the Trump administration’s January deadline looms for states to enforce new Medicaid work requirements, some state lawmakers are turning the tables by pushing to publicly name the largest companies that have employees enrolled in the government program covering low-income and disabled people. California lawmakers seek to revive an expired law that would require the…
Value Is in the Eye of the Beholder
By KIM BELLARD The most (unintentionally) amusing story I read this week was Tim Higgin’s Wall Street Journal article Alex Karp Is Saying What Every Angry CEO Is Thinking About AI. Dr. Karp (yes, he has a Ph.D.), co-founder and CEO of Palantir Technologies, is upset about how AI companies are using relationships with their…
How Fairview Health Services Turned Around a $315M Loss
Fairview Health Services turned a $315 million annual loss into a nearly $600 million turnaround in just two years. At the AHA Leadership Summit, CEO James Hereford broke down the strategy behind the comeback, from workforce redesign to frontline-driven process fixes. The post How Fairview Health Services Turned Around a $315M Loss appeared first on…
Coalition Urges Policymakers to Reject No Surprises Act Enforcement Bill
The Coalition Against Surprise Medical Billing launched a campaign opposing the No Surprises Act Enforcement Act, arguing it would worsen IDR process abuse. The post Coalition Urges Policymakers to Reject No Surprises Act Enforcement Bill appeared first on MedCity News.
What do Medicare Advantage enrollees think about prior authorization? Actions speak louder than words
Do Medicare Advantage enrollees like plans with more prior authorization? On the one han, one would think the answer is a clear ‘no’. However, higher levels of prior authorization could result in lower premiums, a tradeoff many enrollees may prefer. A paper by Marr, Trivedi and Meyers (2026) aims to answer the question using beneficiary…
