In this episode of the MedCity Pivot Podcast, CVS Health Aetna's chief digital and technology officer talks about how the insurance business is using AI, especially agentic AI, in healthcare. Point to note: AI is not used in automatic denials of coverage.
Cold chain is a logistics problem — not just a throughput problem. Pharmacies must rethink their strategy, not just automate it.
In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable.
HHS is reviving a rebate program for 340B drug discounts after the previous pilot was blocked in court earlier this year. Providers say the change will burden already cash-strapped providers with new administrative and financial costs.
The policy conversation needs to shift from just deprescribing alone to building the clinical infrastructure that delivers consistent, high-quality behavioral health care.
The PBM reform efforts are directional, not temporary. Meeting these expectations requires automated systems that can reconstruct claim logic on demand and provide real-time alignment between pricing, rebates and financial outputs.
For someone already managing chronic disease, menopause can disrupt stability and complicate treatment plans in ways that aren’t always immediately visible but show up over time in outcomes and utilization.
Healthcare payments are no longer about transactions. It’s about controlling the revenue cycle. And increasingly, that control is not sitting with ISOs.
The organizations that move now — with the right foundation and the right partners — will enter the next planning cycle with a specialty pharmacy that functions as a true strategic asset.
AI performs best where a problem is well-defined, data-intensive, repetitive and operates at a scale that exceeds human tracking capacity. The supply chain hits all four.
When workers feel stuck in place, with limited opportunities to advance or deepen their skills, disengagement tends to follow. In allied health roles, where burnout is already high and many touch the patient experience, it is a risk healthcare employers cannot afford to ignore.
We aren't killing the problem that fax created. We are migrating it into a format that carries a higher expectation of automated processing — without yet having solved the underlying challenge that made automation hard in the first place.
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
For seniors, the change in policy will dramatically expand access to a revolutionary medication. But there are also significant risks.
How America's outdated insurance model is failing at its most important job
At the center of this issue is a simple question: should the entities responsible for managing prescription drug benefits also own the pharmacies that profit from those decisions?
Delayed remediation and patch latency are no longer just IT and security metrics; they serve as direct reflections of leadership priorities.
Difficult packaging comes with tangible consequences, including lower adherence, higher rates of adverse events, and diminished real-world effectiveness. It can also delay FDA submissions and ultimately, market entry.