AI in Pharmacovigilance: Why Governance Will Define Success
As adoption accelerates, organizations must ensure that the use of AI strengthens and not weakens accountability and patient safety.
MedCity Pivot: How Aetna is Adopting Agentic AI
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.
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From Blind Spots to Better Outcomes: How SNF Data Transparency Strengthens LTSS
What if health plans could identify member decline before an avoidable hospitalization occurs? Real-time clinical visibility into long-stay SNF members uncovers risk earlier and drives better outcomes.
Should You Centralize Cold Chain Fulfillment? Only If You’ve Solved Distribution First
Cold chain is a logistics problem — not just a throughput problem. Pharmacies must rethink their strategy, not just automate it.
HHS Is Reviving Its 340B Rebate Push — And Providers Are None Too Pleased
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.
Better Prescribing, Not Less Prescribing, Is What Behavioral Health Needs
The policy conversation needs to shift from just deprescribing alone to building the clinical infrastructure that delivers consistent, high-quality behavioral health care.
Pharmacy Benefit Operations Infrastructure Must Rise to Regulatory Reform Standards
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.
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The Healthcare Payments Industry Faces a Perception Challenge
Healthcare payments are no longer about transactions. It’s about controlling the revenue cycle. And increasingly, that control is not sitting with ISOs.
Menopause Is an Overlooked Driver of Cost in High-Risk Populations
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.
Specialty Pharmacy Is No Longer Optional Infrastructure
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.
The AI Use Case That Healthcare is Overlooking
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.
Healthcare Retention Depends On Better Pathways, Not Just Better Pay
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.
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Closing the Quality-Affordability Gap in Workplace Mental Health
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.
Don’t Celebrate the Wrong Win: What CMS-0053-F Actually Changes
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.
A Bridge to Nowhere? Medicare’s GLP-1 Coverage Expansion Requires A More Holistic Approach To Weight Management
For seniors, the change in policy will dramatically expand access to a revolutionary medication. But there are also significant risks.
The Myth of Insurance Networks
How America's outdated insurance model is failing at its most important job
When the Referee Owns the Team — and Tennessee Changes the Rules
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?
The Hidden Cost of Slow Cyber Remediation in Healthcare
Delayed remediation and patch latency are no longer just IT and security metrics; they serve as direct reflections of leadership priorities.