More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or delays in care.
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers.
How can AI benefit and improve patient outcome in the emergency department? Watch the latest episode to find out.
Several insurers, such as UnitedHealthcare, Aetna and Cigna, pledged to improve prior authorization. These changes include streamlining decision timelines and increasing transparency.
During AHIP 2025, AHIP executives discussed the impact the proposed budget bill could have on Medicaid and the individual market.
Multiple stakeholders are to blame for prescription drug costs, including pharmaceutical companies and PBMs, according to Merith Basey, executive director of Patients for Affordable Drugs.
In a recent interview, Don Antonucci, president and CEO of Providence Health Plan, spoke about how the industry needs to improve value-based care.
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
During a panel discussion at AHIP 2024, several executives shared their healthcare calls to action, including leveraging AI and rebuilding trust.
During a fireside chat at AHIP 2024, Mary Langowski, executive vice president and president of U.S. healthcare at Walgreens Boots Alliance, said she sees a bright future for retail in healthcare.
Payers face numerous challenges when it comes to AI, but that doesn't mean they shouldn't use the technology, according to Neil Gomes, senior vice president and chief digital officer of AmeriHealth Caritas.
There is a shortage of GLP-1s in the U.S. But experts have differing opinions on whose responsibility it is to be rationing the drugs.
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
AHIP, the AMA and NAACOS released a playbook last week that provides the best practices for value-based care. It is based on experiences from physicians, value-based care entities and payers.
America’s Health Insurance Plans, the Better Medicare Alliance and the Association for Community Affiliated Plans all came out against CMS’ final 2025 Medicare Advantage and Part D rate announcement.
One year after the Medicaid continuous enrollment provision ended, 19.2 million people have been disenrolled from Medicaid, according to KFF. This is higher than many expected, and experts have mixed reviews on how they think this process has gone.
Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.
In submitted comments to the Departments of Health and Human Services, Treasury and Labor, AHIP argued that the proposed mental health parity rule would not expand access to mental health support. It believes the rule should be withdrawn altogether.