Business Intelligence

Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.

Medicare navigation company raises $100M to improve its AI, launch new financial products

Chapter, a technology company based in New York City, said it tripled its revenue last year by filling a market niche designing technology for seniors—specifically, those who have questions about the Medicare program.

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CareCloud hit by data breach that could impact millions

The publicly traded EHR and cloud healthcare IT infrastructure company confirmed in a filing with the U.S. Securities and Exchange Commission that hackers were able to breach its network in March for roughly eight hours, gaining partial access to patient record stores. The incident is being investigated.

Aetna

Pennsylvania health system sues Aetna over alleged ‘downcoding’ of inpatient hospital care

The policy shift by Aetna to reimburse hospital stays of fewer than five days as outpatient observation encounters went into effect in January. The insurer implemented the policy to reduce friction with hospitals that previously had to seek approval for inpatient reimbursement, which was often denied. Jefferson Health is challenging the changes in court.

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Lawsuit against Elevance Health alleging use of ‘ghost networks’ officially moving forward

On Tuesday, a judge formally rejected a motion by the company to have the case dismissed. Carelon Behavioral Health, a subsidiary of Elevance, is accused of publishing an inaccurate directory of providers for those seeking mental health services.

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Oracle cuts thousands of jobs as AI investments fail to pay off

The cloud infrastructure company said in a recent investor meeting that its heavy spending on AI has been complicated by the global GPU and CPU shortage. Some 10,000 workers have reportedly been laid off, but the true number is unknown.

UnitedHealthcare Avery AI Application

UnitedHealthcare launches generative AI ‘companion’ for patient care coordination

The new agentic program, called “Avery,” is now available to millions of UnitedHealthcare members through insurer's existing app. The company said the model will help patients find providers, understand their benefits, get updates on claims and more.

Statue of Liberty New York City healthcare

DOJ accuses New York health system of engaging in anticompetitive business practices

In a complaint filed in federal court, the U.S. Department of Justice claims NewYork-Presbyterian Hospital uses its power of “scale, breadth and configuration” to control payer contracts, making it difficult for insurers to develop low-cost plans. The health system denies any wrongdoing.

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Activist investors sue UnitedHealth to force annual reporting on patient care access

Led by a Quebec-based faith organization, a coalition of investors is asking a court to force UnitedHealth to provide details on the social impacts of its history of mergers and acquisitions. The lawsuit comes after the plaintiffs, all company shareholders, failed to get the proposal passed through internal channels. The Securities and Exchange Commission has also opted not to intervene.