Digitizing Medical Policy Alone Will Not Automate Prior Authorization at Scale
Many health plans are discovering that even after digitizing medical policies and implementing FHIR APIs, prior authorization turnaround times remain slow and provider frustration remains high. The reason is straightforward: digitization alone does not make medical‑necessity determinations executable by automated systems at scale.
As Health Costs Hit Record Highs, Brokers Face a Structural Test
This is forcing brokers to rethink how they serve clients and how their businesses continue to grow without sacrificing service.
Why Healthcare AI Still Can’t Scale — and How Nvidia & Hoppr Are Trying to Fix It
Nvidia and Hoppr are betting that healthcare AI will scale not through standalone applications, but through a new infrastructure layer that lets providers develop and deploy their own imaging models.
CEO of For-Profit MA Plan Tells CMS “Pay Us Less”
Ed Park is sincere and passionate about his calling as the CEO of Devoted Health, which provides Medicare Advantage plans to seniors in 29 states. But it remains to be seen if he can do more or the same with less.
Timely by DrFirst Aims to Lower Barriers to Specialty Meds
Timely by DrFirst launched a tool to streamline prior authorizations and improve access to specialty medications.