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.
CMS’s Final Rule Impacting Star Ratings Puts Outcomes In Focus — Are Health Plans Ready to Take Action?
This is a great opportunity to align your strategies with CMS’s evolving framework by refining care models to focus on impact, investing in digital capabilities that support data use, and continuing to build infrastructure that addresses disparities in care.
The Power of One: Redefining Healthcare with an AI-Driven Unified Platform
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
CMS Finalizes Rule Streamlining Prior Authorization Process
CMS finalized a rule on Wednesday that included set deadlines for affected payers to complete prior authorization requests. Several organizations came out in support of the rule.
Insurers Slam CMS for Medicare Advantage RADV Final Rule
The final rule calls for stricter audits on Medicare Advantage plans. AHIP president and CEO Matt Eyles referred to the rule as "unlawful and fatally flawed."
CMS repeals MA rate disclosure requirement, boosts hospital payments by $2.3B
CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and increase payments to hospitals but will also require facilities to report Covid-19 vaccination uptake among its employees.