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.

Florida probes CVS Health in latest crackdown on PBMs
State Attorney General James Uthmeier is forcing the company to hand over thousands of documents related to its pharmacy contracts and reimbursement policies to see if the retail giant is abusing its position in the market as both a pharmacy benefit manager and a retail chain of drug stores.
Private equity unlikely to dominate cardiology despite hype
Medaxiom CEO Jerry Blackwell, MD, MBA, FACC, discusses investor's interest in buying cardiology practices, noting that PE ownership remains relatively low.
OIG warns of ‘ghost network’ trouble in maternal health managed care
Looking at the three largest Medicaid managed care plans related to maternal health, the Office of Inspector General found instances of ineligible providers being included in directories, as well as other errors such as incorrect contact information.
OhioHealth agrees to void contracts that allegedly punished payers for including competitors in-network
The U.S. Department of Justice said the settlement will save citizens of the state money and open up the market to competition.
Major private payer encouraging employees to leave willingly
The largest Medicaid-specialized managed care organization in the U.S. is offering buyout packages to most of its 60,000 or so staff workers.

Newswatch: AI for Medicare folk, AI uncertainty at the FDA, generative ghosts, more

AI is making patient financial advisors of hospital administrators who used to work in revenue cycle management.

Newswatch: AI-eager doctors, AI-reticent buyers, AI cost worriers, more

In medicine’s next chapter, AI literacy will separate physician leaders from peer followers.

Vintage neon drug sign at the Walgreens pharmacy on Canal Street in downtown New Orleans.

Walgreens settles DOJ opioid crisis case for $300M

The pharmacy chain was accused of filling “millions” of unlawful prescriptions for opioids and other controlled substances. Despite agreeing to the payout, the company does not admit wrongdoing.

artificial intelligence AI in healthcare news

AI newswatch: Lifecyle AI oversight, data matters, AI vs. animals, more

AI may finally end the paper chase caused by prior authorization. Or it may worsen it.

UnitedHealth, Amedisys enter mediation with DOJ over block on $3.3B merger

The two companies have been unable to assuage antitrust concerns raised by the Department of Justice. A magistrate will attempt to hammer out acceptable terms for the home healthcare merger at a conference scheduled for August.

Newswatch: AI researchers weigh in, AI humanizes healthcare, ‘the worst AI will ever be,’ more

Contrary to popular misgivings, AI may be improving the human touch in healthcare.

DaVita kidney care clinics hit by ransomware attack

The company said part of its network has been encrypted. However, it told the Securities and Exchange Commission it is still able to deliver dialysis care to patients.

healthcare surprise billing statement payment

UnitedHealth garnishing claims to recoup ‘loans’ from Change Healthcare hack

UnitedHealth Group said it is seeking repayment of “interest-free” advances distributed to providers struggling during the shutdown of claims processing caused by the ransomware attack on Change Healthcare.

Business Intelligence

Florida probes CVS Health in latest crackdown on PBMs

Private equity unlikely to dominate cardiology despite hype

OIG warns of ‘ghost network’ trouble in maternal health managed care

OhioHealth agrees to void contracts that allegedly punished payers for including competitors in-network

Major private payer encouraging employees to leave willingly