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.
The insurance arm of UnitedHealth Group said the shift is part of its ongoing effort to eliminate the barriers between care delivery and medical coverage. The full list of services exempt from prior authorizations includes diagnostic tests and many outpatient surgeries.
WakeMed, a three-hospital system in the North Carolina capital region of Raleigh, would become part of Advocate Health, Atrium’s parent company, if the deal goes through. Advocate is one of the largest not-for-profit health systems in the U.S.
The New Jersey-based drug developer joins AstraZeneca, Eli Lilly, EMD Serono, Novo Nordisk and Pfizer in offering products directly to patients at a discounted rate. Johnson & Johnson is currently listing four medications on the platform.
The company said in a Securities and Exchange Commission filing that it is cooperating with the Department of Justice’s inquiry into possible incidents of Medicare Advantage upcoding.
Gen Xers and their elders tend to believe AI will do more harm than good. More than half of American adults 50 and older place themselves in that somewhat cynical category.
Over 97% of all counties in the U.S. see high or very high levels of consolidation in Medicare Advantage markets, with UnitedHealthcare and Humana owning the most plans nationwide.
Former Steward Health Care CEO Ralph de la Torre, MD, and other executives are accused in a $1.4 billion legal filing of paying themselves hundreds of millions of dollars in bonuses, despite the health system being insolvent.