Pediatric Innovation Isn’t a Small-Market Problem, It’s an Incentive Problem
Investing in pediatric care is not simply a moral imperative. It is one of the most practical long-term investments the healthcare system can make.
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Strengthening Dental Payment Integrity Through Smarter Claim Editing
Fraud, waste, and abuse (FWA) continue to challenge dental plans as overtreatment, miscoding and inappropriate billing practices drive unnecessary costs and weaken payment integrity. For dental payers, the stakes extend beyond financial losses: these issues can also expose members to unnecessary procedures and consume benefits that should be preserved for appropriate care.
The Hidden Administrative Tasks Draining Small Practices
Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.
Fifty Years of Pediatric Rheumatology, but Children Still Can’t Access the Treatments They Need
As a country, we have developed treatments capable of improving the quality of life and preventing long-term damage for children with rheumatic conditions, yet many children cannot obtain them when they need them most. This needs to change.
Two Years After the Change Healthcare Cyberattack, Healthcare Still Has a Clearinghouse Redundancy Problem
What happened was not just a cybersecurity failure, it was an infrastructure failure.
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Survey Reveals AI Adoption is Accelerating in Healthcare, But Readiness is Not
The 2026 Healthcare AI Readiness Index, a new report by Cotiviti and MedCity News, is based on a survey of 70 healthcare leaders over the summer and shares candid views of how they balance harnessing AI with operational, regulatory and security challenges it creates. Download the report today!
The Missing Piece in Lowering the Cost of Care: Predictability
When the healthcare system defaults to uncertainty, people delay care because it feels safer for their wallets. In some cases, people wait too long, leaving an ER visit as the path of least resistance.
Why Pharma Companies Should Look To Social Media For Better Patient Insight
Healthcare decision-makers, especially at pharmaceutical companies, must prioritize patient input. Data collected from social media listening is a significant step in the right direction.
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A Partnership-driven Approach to Waste and Abuse Prevention
Discover how payers can shift from costly post-payment recovery to intentional prevention through data-driven oversight, accountability, and partnership.
Modernizing Payment Integrity in an Era of Systemic Fraud
Gaps in reimbursement oversight and recovery will only widen, unless plans modernize how they detect, investigate, and recoup improper payments.
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How Payers and Health Plans Think of Identity and the Risks of Fragmented Data
A recent webinar, sponsored by Verato, offered insights from executives at SCAN Health Plan and the Alliance of Community Health Plans on a wide range of tech challenges in healthcare from fragmented data to technology architecture to patient identity.
The True Cost of Focusing on Cost Instead of Cost-Effectiveness
When payors consider only the cost of the medication and not the cost and risk to the patient, doctor, and healthcare system, the irony is that not only is this terrible for patient health, it can be more costly in the end.
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Top 7 Modern AI-Powered EAP Providers for Global Workforces in 2026
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
From Friction to Fix: Measuring What’s Breaking Payer-Provider Trust
Tolerance for this abrasion is gone. It wastes time, drains staff capacity, drives up costs, and affects the patient experience.
Which Health Tech Companies Are Getting Customer Experience Right?
A new report from Forrester offers a score card assessing health tech vendors on customer experience for healthcare organizations considering adopting them.
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Compliance Alone Won’t Fix the Home Health Fraud Problem
With home health fraud growing more sophisticated through AI, post-pay audits are no longer enough. Payers must shift to proactive, tech-driven prevention to catch improper claims before paying them.
The Code Gets You Paid — The Variant Gets You Treated
The between a code that satisfies a payer and the information a physician needs to treat a person, is what nearly every healthcare AI tool is racing past. As we push these systems toward precision medicine and genomics, that gap stops being an annoyance and becomes a patient safety issue.
Moving Beyond Reactive Healthcare: 5 Traits of Successful Healthcare Organizations
A new whitepaper by League highlights examples from collaborations with Baptist Health.