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.

Optum Rx outlines changes to PBM business model, promising price transparency
The company made the changes after its manufacturer rebates for insulin were challenged by the Federal Trade Commission. Among other shifts, Optum said 100% of all rebates will be distributed to customers by 2028.
Heartflow reports significant revenue growth as CCTA sees wider adoption
The company keeps gaining momentum thanks to the success of its AI-powered imaging software.
Bill in Congress would rein in PBMs, force divestment from pharmacies
The Patients Before Monopolies Act was introduced into both the U.S. Senate and House of Representatives with bipartisan support. If it passes, pharmacy benefit managers would be required to divest from retail stores.
CMS pauses new Medicare hospice and home health provider entries for six months
The Centers for Medicare & Medicaid Services said it’s issuing a nationwide moratorium on new providers entering the spaces until it has a chance to look into allegations of fraud, waste and abuse. It confirmed investigations of various organizations are pending.
Consolidation of physician practices proceeds apace, corporatizing medicine one acquisition at a time
The days when most doctors worked in independent practice settings are fading from memory like old photoprints in a musty scrapbook.

Trump’s former FDA commissioner joins board of UnitedHealth

Scott Gottlieb, MD, will take on the new position “effective immediately.” UnitedHealth Group did not say what, if any, steering committee the former FDA lead will sit on.

Cigna announces new copay-centric insurance model, backed by AI care coordination

Dubbed “Clearity,” the new health plans will have four tiers to choose from, allowing patients to select the provider and services that are right for them. The insurance is similar to a concierge care model, but backed by a potentially larger network.

Former COO of UnitedHealthcare subsidiary Optum Health promoted to CEO

Krista Nelson made the official announcement on LinkedIn. She replaces Patrick Conway, MD, CEO of the broader Optum, who had held dual roles. Nelson has been with UnitedHealthcare since 2017.

Apple has officially introduced the Apple Watch Ultra 3, which will provide notifications when it detects signs of chronic high blood pressure once the technology is cleared by the U.S. Food and Drug Administration (FDA).

U.S. International Federal Trade Commission reviews ban on new Apple Watch pulse oximeter

Masimo’s complaint over the new version of the Apple Watch could lead to an import ban if it is found that the technology infringes on its patents.

mergers and acquisitions M&A consolidation puzzle business deal

Fabric acquires UMC Digital Health to expand its virtual care customer base

The financial terms were not disclosed. The acquisition adds 400 new payers, health systems and employers who offer virtual care benefits to Fabric's portfolio.

Illustration showing how procizumab captures circulating dipeptidyl peptidase 3 (cDPP3) to block this key molecular driver of shock. Illustrations courtesy of 4TEEN4

$64M raised for new cardiogenic shock drug—research already underway

Procizumab was developed to change the trajectory of shock by addressing an underlying molecular driver rather than just managing symptoms.

UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

Starting in 2026, patients covered by UnitedHealthcare's Medicare Advantage and commercial plans will not have care reimbursed for instances of remote patient monitoring unless they have diagnosed heart failure or are pregnant and experiencing hypertension. The shift stands at odds with traditional Medicare, which added new claims codes for providers to use next year.

Healthcare supply giant Medline announces IPO, valued at $50B

The company announced its IPO filing on Tuesday. Medline said it expects new investors to bring in a $5 billion influx of funds. A date has not been set for the stock’s listing on NASDAQ.

Business Intelligence

Optum Rx outlines changes to PBM business model, promising price transparency

Heartflow reports significant revenue growth as CCTA sees wider adoption

Bill in Congress would rein in PBMs, force divestment from pharmacies

CMS pauses new Medicare hospice and home health provider entries for six months

Consolidation of physician practices proceeds apace, corporatizing medicine one acquisition at a time