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 Advantage insurer accused of upcoding by a whistleblower settles False Claims Act lawsuit for $22.5M
Independence Blue Cross, the largest medical insurance provider in the Philadelphia area, does not admit to wrongdoing. It was accused in a lawsuit backed by the U.S. Department of Justice of misrepresenting the severity of patient illnesses to juice risk-adjusted Medicare payments.
Housing AI company hits $4B valuation as it expands into healthcare
With its $350M in new funding, EliseAI said it plans to build out its technology and sales force. It currently works with specialty provider groups to automate practice operations such as scheduling and insurance verification.
Rural cardiology practices struggle to fill vacancies
A new survey put a spotlight on the staffing issues rural cardiology practices and health systems face on a daily basis.
Some physicians not only avoid burnout but also find fulfillment. Here’s how they do it.
Of surveyed and interviewed U.S. physicians who showed significant six-month improvement in follow-up vs. baseline wellness checks, 47% attributed the gain to active personal changes. Not far behind were those who credited active work-related changes—40% of the field.
Mayo Clinic, Thermo Fisher Scientific launch new AI-supported diagnostics company
The new entity, Precure, will be owned by both groups. Its work in detecting early disease for timely intervention stems from a research project launched this summer. The Mayo Clinic said Precure will make the results of that initiative actionable.

artificial intelligence AI in healthcare

Report: Harvard Medical School data backing healthcare-focused Microsoft Copilot update

According to the Wall Street Journal, insider sources said a major update to Microsoft’s AI chatbot could be released before the end of the month, designed to be more reliable at answering medical queries.

Nonprofit investors seek ‘checks and balances’ at UnitedHealth

The Accountability Board has submitted an official proposal for UnitedHealth Group to separate its CEO and board chair positions, both currently held by Stephen Hemsley.

Healthcare market research firm Press Ganey scooped up in $6.75B AI merger

Qualtrics, which uses artificial intelligence to measure public satisfaction and consumer trends, is buying Press Ganey outright, citing the need for more healthcare-specific data to improve its technology.

Duke Health, Aetna reach agreement to keep members in-network

The new contract was signed just ahead of the Oct. 20 deadline. The insurer and academic health system were in dispute over reimbursement rates. The exact terms of the new multi-year agreement are unknown.

Trump, Pfizer announce ‘TrumpRx’ following tariff exemption deal

The new "TrumpRx.com" will sell Pfizer drugs at a heavily discounted price, direct-to-consumers. However, details on the initiative are not entirely clear.

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Saint Mary’s awarded $510M in damages in lawsuit against Universal Health Services

Universal Health Services was found by a jury to be liable for fraud in an alleged scheme to destabilize Saint Mary’s during the COVID-19 pandemic. The ruling includes punitive damages.

Bankrupt Exactech settles case of faulty knee implants for $8M

The settlement was reached with the U.S. Department of Justice as part of Chapter 11 proceedings. Exactech is currently under restructuring that will see its business bought out by multiple investment firms.

As the national physician shortage deepens, cardiology is feeling the strain—especially in rural America. Recruitment challenges are growing, and health systems are grappling with how to attract and retain cardiologists in remote locations. Michelle Wimberly, director of physician recruitment and retention at Cardiovascular Logistics (CVL), says the solution starts with relationships and a commitment to long-term engagement.

How to bring cardiologists to rural America during a physician shortage

As the national physician shortage deepens, cardiology is feeling the strain. Recruiting cardiologists can be hard enough—bringing them to rural America is especially challenging due to the risk of isolation and other concerns.

Business Intelligence

Medicare Advantage insurer accused of upcoding by a whistleblower settles False Claims Act lawsuit for $22.5M

Housing AI company hits $4B valuation as it expands into healthcare

Rural cardiology practices struggle to fill vacancies

Some physicians not only avoid burnout but also find fulfillment. Here’s how they do it.

Mayo Clinic, Thermo Fisher Scientific launch new AI-supported diagnostics company