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.

Florida hospitals sue nonprofit over ‘pay-to-play’ safety rankings

Five Tenet Healthcare hospitals are suing the Leapfrog Group, accusing the organization of pressuring hospitals to share internal data in exchange for higher scores in its annual safety rankings. The watchdog outright denies the claim.

Tariffs not enough to make Siemens Healthineers move production or raise prices—yet

The imaging manufacturer expects to spend between $227 million and $340 million on tariff mitigation efforts, leaders said Wednesday.

Rite Aid seeking buyout as it files for bankruptcy—again

For the second time in less than two years, the struggling retail pharmacy chain has filed for Chapter 11 bankruptcy protection, seeking buyers as it prepares for store closures.

artificial intelligence AI in healthcare

Healthcare AI newswatch: UnitedHealth hearts AI, agentic AI again, healthcare AI dependency, more

Give healthcare workers AI to do their jobs and you might make them AI-dependent. Give them AI anyway?

DOJ sues Aetna, Humana and Elevance for allegedly paying illegal kickbacks

The three insurance giants are accused of conspiring with brokers to enroll profitable patients in Medicare Advantage plans, in exchange for "hundreds of millions" in kickbacks.

overpromising AI artificial intelligence capabilities

Healthcare AI newswatch: Devices of unknown generalizability, promises of uncertain keepability, more

Overpromising AI capabilities to hospital stakeholders—now there’s a mistake healthcare AI enthusiasts have been known to make.

AHA warns ‘perfect storm’ threatens hospitals with rising costs, reimbursement cuts

In a new report, the AHA said strains from President Trump’s tariffs and struggles with Medicare Advantage plans are creating “financial headwinds” that could shake the economic stability of hospitals nationwide.

CVS Health’s Aetna to withdraw from ACA insurance marketplaces next year

The company cited declining enrollment as the reason for exiting the exchanges, including from patients seeking Medicare options.

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