Confirmed diversion cases do not equal true prevalence - they are directly dependent on investigative proficiency, tooling, and the bandwidth of the teams doing the work.
At a time when 98 million prescriptions are abandoned due to cost surprises, it’s critical that all four categories of prescription drug prices are available so consumers can determine how to obtain needed medications at the lowest cost.
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
As healthcare data explodes, agentic AI has emerged as a solution to validate medical information through specialized agents working together behind the scenes.
While there is a significant need and opportunity to address this overall spend with advanced AI tools that predict patient needs and readmission likelihood, intrinsic biases within these algorithms ultimately cause more harm than good and financial savings are being achieved at the expense of patient’s health.
We are building a more connected system that bridges acute and post-acute settings by uniting insights across the continuum. The insights empower clinicians with the information they need at the moment they need it, resulting in faster, safer, and more human-centered care.
CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They’re designing utilization management systems that are clinically sound, operationally efficient, and aligned with enterprise goals.
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
Despite all the noise around the updates, there’s one area that’s been conspicuously absent this year: enforcement of patient estimate requirements.
Leading in healthcare when the odds are stacked against you is not about eliminating the challenges. It is about meeting them without losing sight of the reason we chose this profession in the first place.
Health care in the United States is confusing for patients and consumers. Price transparency is a step in the right direction — transformative change can happen by combining cost, quality, appropriateness and efficiency measures.
Here are five guidelines to help employers balance health outcomes and financial responsibility to ensure that GLP-1 coverage is effective, affordable, and aligned with improved health and workforce well-being for employees and their families.
Across the nation, state-based health insurance exchanges are searching for ways to better serve their communities while making enrollment easier, more personal, and more accessible for everyone.
This new standard was developed to address the rise of telehealth, cybersecurity risks/compliance in ePrescribing, data needs, AI, and the growing demand for patient transparency. So what is the Standard solving for, and what can providers expect?
Imagine360 has launched a new product called Complete Care, which includes a pharmacy benefit solution named Imagine360Rx.
Those who recognize that AI governance is an innovation enabler will be able to align business priorities and AI investments — and make smarter decisions about which models to accelerate, and which to retire — ultimately leaving the enterprises better positioned to achieve ROI on their AI.
By reimagining the payment experience through transparency, flexibility, and technology, providers can drive better outcomes for both their bottom line and the patients they serve.
As real-time inference overtakes training-centric approaches, a pivotal question emerges: how can the human element remain central in an increasingly autonomous ecosystem?