Supply Chain Startup SpendRule Launches With 4 Health System Customers
Backed by Abundant Venture Partners, company focuses the power of AI on helping health systems prevent overpayments on purchased services
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Prior Authorization Is Broken. CMS’s New Rule Shows Why Regulated AI Is the Way Out
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…
Why HealthTech Products Fail Clinical Deployment & How To Prevent It
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…
Health Insurer Financial Performance in 2024
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…
As More Americans Embrace Anxiety Treatment, MAHA Derides Medications
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…
New Orleans Brings Back the House Call, Sending Nurses To Visit Newborns and Moms
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…
Estados rojos y azules buscan limitar el uso de la inteligencia artificial en seguros de salud. Trump quiere lo opuesto
¿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…
The Rural Care Crisis Is an Economic Issue, Not Just a Public Health One
As hundreds of rural hospitals face the risk of closure, healthcare leaders warn that the fallout extends far beyond patient outcomes. During a panel at ViVE in Los Angeles, healthcare leaders outlined how access to care underpins the economic stability of rural America. The post The Rural Care Crisis Is an Economic Issue, Not Just…
What Experts Say About Hims & Hers’ $1.15B Acquisition of Eucalyptus
Experts say Hims & Hers’ acquisition of Eucalyptus positions the company for global expansion and revenue diversification amid U.S. GLP-1 regulatory challenges. The post What Experts Say About Hims & Hers’ $1.15B Acquisition of Eucalyptus appeared first on MedCity News.
Why Providers Can’t Ignore CMS Audits
At the end of the day, it doesn’t matter what your patient mix looks like; your notes can and will be pulled into audits. Waiting until CMS is at your doorstep isn’t a strategy — it’s a risk. Now is the moment to get ahead of it. The post Why Providers Can’t Ignore CMS Audits…