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.

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Healthcare AI newswatch: Consumer mistrust, humanoid robots, vendor wars, more

Healthcare consumers are wary of healthcare systems packing AI.

veterans health administration efficiency

DOD contractor hit with $11M fine for health data mismanagement

A U.S. military contractor has agreed to an $11.2 million settlement with the U.S. Department of Justice to resolve allegations it lied about properly securing sensitive patient data tied to the Tricare program.

UnitedHealth pushes back against shareholder transparency proposal

In an SEC filing, the insurer argues that requests by investors for more reporting on claims denials may already be satisfied through its regulatory compliance processes.

UnitedHealth hires law firm, demands doctor recant statements on social media

According to a report from Bloomberg Law, UnitedHealth has hired a prestigious defamation law firm to police what it deems as misinformation posted online.

Healthcare AI newswatch: UnitedHealth lawsuit, humanized medical AI, mobile AI care clinics, more

A federal judge has vacated five of seven complaints against UnitedHealth Group—yet is allowing the AI-implicated suit to advance.

Superbowl GEHA Field at Arrowhead Stadium

Nonprofit academic hospital receives criticism after running Super Bowl ad

U.S. House Rep. Greg Murphy, MD (R-NC), scolded the CEO of NYU Langone for buying the expensive ad, requesting in an open letter that the hospital release financial data related to its cost.

Private equity tied to 21% of healthcare bankruptcies for second consecutive year

New data from the Private Equity Stakeholder Project reveals that, while 11% of all-sector bankruptcies were filed by organizations with a history of ownership by investment firms, that number rises to 21% for healthcare.

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Mexico, not China, is biggest tariff concern among radiology vendors

If 25% tariffs go into effect, it could have a big impact on the cost of medical imaging and radiotherapy systems, with many manufacturing facilities in Mexico.

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