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.

Optum Rx outlines changes to PBM business model, promising price transparency
The company made the changes after its manufacturer rebates for insulin were challenged by the Federal Trade Commission. Among other shifts, Optum said 100% of all rebates will be distributed to customers by 2028.
Heartflow reports significant revenue growth as CCTA sees wider adoption
The company keeps gaining momentum thanks to the success of its AI-powered imaging software.
Bill in Congress would rein in PBMs, force divestment from pharmacies
The Patients Before Monopolies Act was introduced into both the U.S. Senate and House of Representatives with bipartisan support. If it passes, pharmacy benefit managers would be required to divest from retail stores.
CMS pauses new Medicare hospice and home health provider entries for six months
The Centers for Medicare & Medicaid Services said it’s issuing a nationwide moratorium on new providers entering the spaces until it has a chance to look into allegations of fraud, waste and abuse. It confirmed investigations of various organizations are pending.
Consolidation of physician practices proceeds apace, corporatizing medicine one acquisition at a time
The days when most doctors worked in independent practice settings are fading from memory like old photoprints in a musty scrapbook.

Clinical, IT leaders plan to boost spending on AI, other technologies

Look for AI, 5G and big data analytics to lead all other emerging technologies in reshaping U.S. healthcare over the next several years.

private equity corporatization business consolidation

Private equity-backed healthcare services bring more harm than good to patients, report reveals

Given the rapid growth of PE ownership in healthcare, the report's concerning data give pause to how such entities should be regulated, experts involved in the work suggested.