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Antiracism in AI: How to Build Bias Checkpoints Into Your Development and Delivery ProcessMuch of the data that AI depends on is tainted with racial bias.
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Understanding the Long-Term Implications of Medicaid UnwindingIt’s time to talk about the ramifications of pulling the rug out from the low-income and disabled individuals who rely on Medicaid’s basic healthcare services.
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We’re in a Golden Age of Obesity Treatment, but Insurance Coverage Is LaggingMany private insurers consider antiobesity medications to be 'vanity drugs,' and the refusal to cover obesity treatment is counterproductive because of obesity's many health consequences. But attitudes are changing, and a law extending Medicare coverage to antiobesity treatment is gaining traction.
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How to Relieve the Pressure of High-Deductible Healthcare on PatientsPatient deductibles are likely to continue rising in coming years, and healthcare providers will have to implement strategies to continue providing patients with the best possible care.
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How Physician-Led, In-Home Care Can Save Lives During the Pandemic and BeyondDr. Karen Vloedman shares her learnings that will help inform best practices to assist payers and provider groups when preparing for and navigating the CoVID-19 pandemic.
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With Nurse Burnout at an All-Time High, Offer Tangible ReliefTechnology is the key to giving nurses more time to focus on patients.
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TAVR Equal to Surgery in Low-Risk Patients with Severe Aortic Stenosis | ACC 2025Researchers found that at five years, patients with severe aortic stenosis who were treated with either TAVR or surgery had comparable rates of all-cause mortality or disabling stroke.
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How Much Will Telehealth Go “Back to the Future” Following the Pandemic?Prior to the COVID-19 pandemic, telehealth was more of a stretch goal than a reality for most providers despite the seeming prevalence of video conferencing.
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AI Soups up Payer Operations | Predictions for 2025Kim Perry, chief growth officer of Emtelligent, shares her prediction for 2025.
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Ensure You Partner With Problem Solvers, Not Problem FindersWhat’s more valuable than the ability to identify problems within your business plan or strategy? The ability to find solutions to those problems before they arise.
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Key Takeaways Following MAJIC-PVGabriela Hobbs, MD, and Timothy Mok, PharmD, BCPS, BCOP, close the discussion with key takeaways for payers to consider related to ruxolitinib and insights on future research.
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Perspectives and Future Directions in Biosimilar Health Care DeliveryA panelist discusses how managing biosimilars requires close collaboration between payers and health systems to optimize patient care and cost savings, while sharing insights about program implementation challenges across different care settings and emphasizing the importance of robust operational frameworks.
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Patient-First Practices: A Strategic Approach to International HealthcareA substantial reduction in claim costs can be persuasive and attention-grabbing, but without assurances of continuity of care and proper clinical oversight, the ultimate goal of positive patient health outcomes can be elusive — and costly.
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Leaning into Digitization to Improve Patient Satisfaction and Optimize OperationsAs patients become discerning consumers of healthcare, providers are focused on implementing processes and technologies that enhance the entire experience, from care delivery through to payment obligations.
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Unlocking Better Health: Why Health Literacy Needs a Digital RevolutionArtificial intelligence stands out as a particularly promising solution to the challenges of improving health literacy.
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Addressing Ransomware in HealthcareThere have been an alarming increase of ransomware attacks on healthcare systems in 2021—with more than 65 reported ransomware attacks on healthcare organizations in the third quarter alone and two-thirds of organization reporting that they had been targeted by ransomware strikes—a trend that is likely to continue in 2022.
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Ghost Network BustersAudits and AI might help deal with the problem of woefully inaccurate provider directories supplied by insurers to their members.
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2023 PFS Final Rule: 8 Key Strategies That Boost New ACOs, Increase Healthcare AccessThe 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer.
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What the Trump Presidency Will Mean for U.S. Healthcare and Managed CareThis webinar on "What the Trump Presidency Will Mean for U.S. Healthcare and Managed Care" includes panelists Lindsay Greenleaf, J.D., MBA; Ryann Hill, M.P.H. and Patrick Cooney, discussing possible changes to healthcare policies and programs under the Trump administration, including the future of the Inflation Reduction and Affordable Care Acts, PBM reform and Medicare Advantage.
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What Shifting U.S. Demographics Mean for Health PlansThe country is becoming more diverse. Health plans need to adapt by making their provider networks as diverse as possible and committing to diversity in their management ranks.
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4 Tactics to Address Uptick in CARES-Related Billing and Other Claims DenialsWith the uptick in claims denials, which have increased sharply due to CARES-related provisions, the onus is on providers to directly address a problem that’s only going to get worse as we continue to work our way through the COVID-19 pandemic. Recommended is a 4-pronged approach for providers to address this.
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Needed: A Prevention Strategy To Stop Amputations Among Minority Populations Living With Complex DiabetesLower limb amputations are devastating for people living with diabetes, particularly for Black Americans facing poor access to comprehensive care. A coordinated, data-driven national prevention strategy is the only way to curb this growing epidemic for all at-risk populations.
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To Avoid Falling Off the Telehealth Cliff, Education Needs to be a PriorityThe resulting spike in telehealth use exceeded expectations, with an 11,718% increase in remote Medicare visits between March and April 2020.
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24/7 Nurse Triage vs AI: Enhancing Ambulatory Care, Shielding Against Under-TriageThe need for tools that effectively route patients to the right care at the right time has intensified. But relying only on a tech-enabled approach heightens the potential for missed human connections.
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Female Carriers of X-Linked Retinal Diseases Advocate for Gene Therapy AccessMany carriers reported feelings of concern, anxiousness, and guilt for passing the X-linked inherited retinal disease to their children—and 78% of respondents in a new study believe that carriers should have access to gene therapy options.
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Minimize Downtime, Maximize Uptime: Key Network Strategies for Healthcare Facilities to EmployData revealed that just one minute of downtime costs the average business $5,600.
