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.

Elevance pays CMS $342M to assuage concerns of noncompliance and overbilling
The Medicare Advantage insurer said the payout is equal to what a CMS audit stated was the total amount the company was overpaid for patient care services. Despite receiving the cash, the agency has yet to officially withdraw its enforcement action, as the two parties are still negotiating.
Top GLP-1 prescription indications include sleep apnea, depression and kidney disease, study finds
A report from Trilliant Health looking at payer data found that, as prescriptions for the popular weight loss drugs spike, so rises the number of approved benefits.
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.

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.

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Report: Johnson & Johnson wants to sell its stroke business for more than $1B

Johnson & Johnson has reportedly had early discussions with potential buyers about its Cerenovus division of stroke products.

Healthcare AI newswatch: End-of-life AI, deepfake healthcare workers, AI drug prescribers, more

End-of-life decisions are often anything but easy. AI might be able to help.

Gottlieb: Let’s not slap the label ‘medical device’ on AI software that only helps clinicians make care decisions

Standing FDA guidance reflects concern over physicians deferring to AI-aided CDS recommendations when pressed for time or uncertain of their own judgments. Is that stance outdated?