VBC aligns reimbursements to outcomes, emphasizing the quality and effectiveness, not quantity, of healthcare activities. But the same cost constraints driving interest in VBC can also turn it into a liability.
Health tech investors say the founders who win them over aren't the ones with all the answers, but the ones who know exactly what they don't know — and build a team to cover the gap.
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.
Unlike past healthcare tech waves sold on cost savings, AI is proving it can generate new revenue — with returns as high as 100x, according to a panel of investors at MedCity News' Bullseye event.
Assured Health raised $19 million for its AI agents that verify provider credentials and manage insurance enrollment for health systems and group practices. The startup said it can cut a process that usually takes months down to days.
At the end of the day, the most important question is a simple one: Do you actually know if you’re being reimbursed correctly?
As hospitals increasingly use AI to improve patient care, the same technology is being used by hackers and nation-states to launch faster, more sophisticated attacks. Karen Habercoss, chief information security and privacy officer at the University of Chicago Medicine, explained how her health system is building a governance structure to manage that risk.
We'll explore why the next era of payer performance will depend on building a trusted data foundation that connects people, providers, and relationships across the enterprise.
HSS chief digital and information officer Ashis Barad, who has worked on both the payer and provider sides of healthcare AI, thinks the industry's growing "bot vs. bot" battle over prior authorizations and appeals is driving costs up. To him, the real fix lies in providers and payers sharing data to build more personalized care pathways.
CMS' proposed 2027 Physician Fee Schedule would bar Medicare payment for remote monitoring services delivered by third-party vendors, following OIG reports that flagged widespread fraud in the space.
This is not an argument against capital in independent medicine. Practices need infrastructure, and physicians have legitimate reasons to seek liquidity. It is an argument that the exit stage carries a risk this market has not yet priced.
Fairview Health Services turned a $315 million annual loss into a nearly $600 million turnaround in just two years. At the AHA Leadership Summit, CEO James Hereford broke down the strategy behind the comeback, from workforce redesign to frontline-driven process fixes.
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
It usually tracks some version of value delivered, where more customers lead to more usage and more revenue. However, in healthcare, the blind pursuit of revenue can cause real harm.
As Kaiser Permanente CEO Greg Adams touted the success of his organization’s value-based care models at the AHA Leadership Summit in Denver, Kaiser nurses outside protested the health system's AI strategy. They claim they're being excluded from decisions about the technology.
A former Mayo Clinic research director claims she was silenced, demoted and ultimately fired for sounding the alarm on AI safety and patient privacy lapses at the health system. Traci Tamiko Eto is now suing Mayo for retaliation.
The honest question is not whether AI will end the fight. It will not. The honest question is what AI does to a fight that has been structurally imbalanced for 30 years.
For many of Medicaid’s highest-need members, the problem isn’t that services don’t exist. It’s that the system can’t consistently reach the people who need those services most.