News
Nearly all surveyed health system executives believe that digital and AI tools can help them move to more proactive care. Most see key areas as providing off-campus care, using CRM systems to schedule ongoing…
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What You Should Know:
– The U.S. Department of Health and Human Services (HHS) has announced a new regulatory reform that will give doctors and patients real-time access to prescription drug information.
– The rule, which…
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Shannon Smith, Assistant VP of Clinical Success at Zyter|TruCare
As they navigate complex times, health insurers have their eye on two important financial indicators. And both are moving in the wrong direction. Costs are on…
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Top News
Major US health insurers pledge to improve prior authorization practices. They aim for 80% real-time decisions by 2027, fewer procedures that require approval, and 90-day care continuity for patients who switch plans.
Insurer…
Vermont Governor Phil Scott has signed groundbreaking legislation that significantly expands the Green Mountain Care Board’s authority to regulate the financial health of hospitals and insurance providers throughout the state. This comprehensive healthcare reform…
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Data from the J.D. Power 2025 U.S. Healthcare Digital Experience Study revealed that health insurance members enrolled in health plans and Medicare Advantage plans use their plan websites and mobile apps as their primary…
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What You Should Know:
– Health insurance members, both in commercial and Medicare Advantage plans, are increasingly relying on their health plan’s websites and mobile apps for communication. However, these digital experiences are falling short…
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Healthcare Redefined Through AI Innovation
Health insurers are leveraging artificial intelligence to redefine their role in healthcare delivery. At HIMSS25‘s inaugural Emerge Innovation Experience in Las Vegas, industry leaders revealed how AI is empowering payers…
AI Systems Driving Record Denial Rates
The 2024 American Medical Association survey reveals alarming trends in prior authorization practices, with 61% of physicians concerned about health insurers’ increasing reliance on unregulated artificial intelligence systems. According…
What You Should Know:
– A new survey from the American Medical Association (AMA) reveals growing concern among physicians about the use of artificial intelligence (AI) in prior authorization decisions by health insurers.
– The survey…
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