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.

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.
HHS-OIG audit finds that major Medicare Advantage insurers engaged in $180M of alleged upcoding
The payers in question, Humana and UnitedHealthcare, deny any wrongdoing and are not obligated to pay back any money.
$5.2B healthcare RCM giant Waystar seeking buyer, report reveals
Any negotiations are currently in the early stages, sources told Reuters. If a deal closes, Waystar could be taken off the stock market and restructure itself as a private business.
3 ways to cut specialists’ wait times without adding more specialists
Add lanes to a highway and the traffic only gets more congested. Add doctors to a local health system and waiting times increase. What explains these parallel paradoxes?

Dispute between Johns Hopkins and UnitedHealthcare pushes patients out-of-network

The two said they’ve been negotiating terms for eight months. Sticking points include denied claims and coverage disputes, with both the insurer and health system pointing fingers.

Court approves $2.8B BCBS class-action settlement; insurer to make changes

The settlement reached in October 2024 has been finalized. A fund is being set up for the estimated 3 million claimants, as BCBS pledges to reform its BlueCard health plans.

Ransomware attack on DaVita kidney care clinics exposes 2.7M patients

The initial incident happened in April. Since that time, the notorious cybercrime cell Interlock has claimed responsibility. A data dump from the breach was put up for sale on the dark web.

UnitedHealth forms ‘public responsibility committee’ to improve its reputation

The insurance giant is charging the new board committee with monitoring company policies related to prior authorizations, claims adjudication and AI. The group is scheduled to meet four times a year.

B. Braun recalls IV solutions over serious patient safety risks

Two lots of IV solution bags from the company were found to contain particulate matter that could cause blockages in blood vessels, killing a patient. To date, no serious adverse events have been reported.

healthcare insurance fraud scam scheme legal lawsuit

CVS Caremark hit with $289M judgment following whistleblower claim

That number includes $285 million in damages. CVS Health’s PBM was found to have committed fraud when it pressured insurers to overbill Medicare Advantage plans for patient care services.

cybersecurity hacker ransomware cyber data breach

Biopharma company confirms ransomware attack as 176 GB data trove is posted

Indiana-based Inotiv confirmed the data breach in a filing with the U.S. Securities and Exchange Commission. Infamous cybercrime cell Qilin has claimed credit for the attack.

FTC challenge to Edwards JenaValve acquisition could delay FDA approval

Edwards Lifesciences asked the U.S. Federal Trade Commission (FTC) this week to dismiss the complaint against the company's acquisition of JenaValve this week. A healthcare market analysis firm also said the FTC actions will likely impact the timing of an FDA clearance of the Trilogy heart valve.

Business Intelligence

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

HHS-OIG audit finds that major Medicare Advantage insurers engaged in $180M of alleged upcoding

$5.2B healthcare RCM giant Waystar seeking buyer, report reveals

3 ways to cut specialists’ wait times without adding more specialists