CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers.
More Than 50 Health Plans Commit to Simplifying Prior Authorization
Several insurers, such as UnitedHealthcare, Aetna and Cigna, pledged to improve prior authorization. These changes include streamlining decision timelines and increasing transparency.
What Are Healthcare Organizations Getting Wrong about Email Security?
A new report by Paubox calls for healthcare IT leaders to dispose of outdated assumptions about email security and address the challenges of evolving cybersecurity threats.
AHIP CEO on the Budget Bill: “We Are Very Concerned About the Impact on Coverage”
During AHIP 2025, AHIP executives discussed the impact the proposed budget bill could have on Medicaid and the individual market.
Who Is Responsible for the High Cost of Prescription Drugs? One Advocate Weighs In
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.
What’s Missing from Value-Based Care Convos, According to Providence Health Plan’s CEO
In a recent interview, Don Antonucci, president and CEO of Providence Health Plan, spoke about how the industry needs to improve value-based care.
Healthcare Execs’ Urgent Calls To Action
During a panel discussion at AHIP 2024, several executives shared their healthcare calls to action, including leveraging AI and rebuilding trust.
Solving Healthcare’s Provider Data Problem Starts with Interoperability
Break down the silos. Take control of your provider data.
Why Walgreens’ US Health President Is ‘Bullish’ on the Role of Retail in Healthcare
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.
AmeriHealth Caritas Exec: Worst Thing Insurers Can Do Is Be Paralyzed by AI Challenges
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.
Who Should Be Responsible for Rationing GLP-1s?
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.
AHIP, AMA, NAACOS Release Playbook for Value-Based Care
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.
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The 3 Best Options to Buy Telemedicine Carts for Neurology Care
Neurologists and health care practitioners must evolve with the world. Telemedicine carts assist in this evolution by serving as an intermediary between patients and doctors.
Insurer Advocacy Orgs Slam Final MA, Part D Rate Announcement
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.
1 Year Later: How Has the Unwinding of Medicaid Continuous Enrollment Gone?
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.
Healthcare Moves: A Monthly Summary of Hires and Layoffs
Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.
AHIP: Proposed Mental Health Parity Rule Should Not Be Finalized
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.
Healthcare Moves: A Monthly Summary of Hires and Layoffs
Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.