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.

Blue Cross Blue Shield of Michigan accused of ‘anticompetitive conduct’ as part of a ‘Blue Conspiracy’
The state is accusing the insurer of colluding with the broader Blue Cross Blue Shield network to stifle competition and control prices. BCBSM denies the allegations.
Last year’s healthcare data breach at Oracle impacted 20M people: Report
The hack, which was revealed earlier this year in a report from Bleeping Computer, is said to have been limited to a legacy server. Oracle denied its cloud environment had been compromised.
FTC sends warning to dozens of hospitals over price transparency failures
The agency is warning hospitals that failing to publicly post the prices they charge for services will not only elicit the ire of HHS.
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.

Combined AI chatbot, telehealth app earns $25M investment

Physician-founded Counsel Health said it will use the funds to hire more doctors as it expands the userbase for its AI, which allows patients to ask questions and get answers from a real doctor.

CVS Health announces $10.6B acquisition of Oak Street Health

CVS finalizes buyout of Rite Aid prescription data, 63 retail stores

The prescription information comes from 626 pharmacies in 15 states. CVS said it could gain access to 9 million new customers.

Johnson & Johnson to spin off $9.2B DePuy orthopedics division into independent company

The division develops and manufactures knee and hip replacements, along with other surgical implants. J&J said it will separate DePuy within 18 to 24 months, at which point it will be the largest orthopedics company in the world.

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.

Business Intelligence

Blue Cross Blue Shield of Michigan accused of ‘anticompetitive conduct’ as part of a ‘Blue Conspiracy’

Last year’s healthcare data breach at Oracle impacted 20M people: Report

FTC sends warning to dozens of hospitals over price transparency failures

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