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.

Number of physicians working for small practices drops below 50% for the first time, AMA says

A new report from the American Medical Association reveals that doctors are increasingly likely to work for larger provider groups and hospitals, as single specialty practices slowly disappear.

Cigna, CVS sue to block Arkansas' PBM regulation

The newly signed law, known as Act 264, bans pharmacy benefit managers from owning pharmacies in the state. It's scheduled to go into effect beginning in 2026.

Healthcare AI newswatch: MAHA’s AI stumble, OpenAI’s healthcare offensive, Mayo’s AI startup support, more

Mayo Clinic is looking to give promising medtech startups a seriously running start. Toward that end, the august institution has launched the new Mayo Venture Partner program.

Walmart launches AI tool to steer Medicare Advantage members toward ‘healthy’ foods

Walmart is highlighting food and products eligible for purchase using Medicare Advantage supplemental funds through its app, while also using AI to algorithmically help enrollees build diet-appropriate shopping lists.

Rishi Wadhera, MD, MPP, MPhil, associate director of the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and an associate professor of health policy and management, Harvard School of Public Health, explains the impact of private equity ownership of hospitals and private practices.

Private equity's influence continues to rise in cardiology—what does that mean for patient care?

Rishi Wadhera, MD, MPP, MPhil, a cardiologist who also specializes in healthcare policy, spoke to Cardiovascular Business about the good, the bad and the unknown when it comes to private equity's role in cardiology.

Q&A: Universities, tech collaborate to predict opioid overdose with wearables

The Digital Medicine Society has partnered with organizations such as Duke University and Google Fitbit to leverage wearable technology and smartphone data in reducing opioid relapse and overdose deaths. As the pilot study gets underway, HealthExec speaks with Candice Taguibao, associate program director at the Digital Medicine Society, to learn more about the initiative.

openAI united arab emirates UAE artificial intelligence

AI newswatch: OpenAI goes to the UAE, patients get cyberchondria, more

Like remoras hitching a ride on a shark, private businesses are capitalizing on President Trump’s AI-aggressive trip to the Middle East.

Report: UnitedHealth rewarded nursing homes for delaying hospital transfers

Citing evidence from documents and interviews, the Guardian released an exposé accusing UnitedHealth of directly influencing the day-to-day operations of some 2,000 nursing homes, resulting in patients not receiving necessary emergency care.

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