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Humana and Providence launch a scalable data exchange collaboration that will use HL7 FHIR standards and modern APIs to reduce administrative burden, enhance interoperability, and support value-based care.
The payer-provider collaboration’s…
The following is a guest article by Phyllis Wojtusik, RN, Executive Vice President, Value-Based Care at Real Time Medical Systems
Hospitals are about to take on greater responsibility for patient outcomes—extending well beyond discharge. Beginning…
It’s open enrollment season for Medicare. Patients and their family members inundate physicians with questions about whether they should switch plans.
Most outpatient office visits are too short to have a meaningful conversation about…
Arun Hampapur, PhD – Co-Founder & CEO, Bloom Value; Fellow, IEEE
Implementing AI in Risk Adjustment for Managed Care is like adding rocket fuel to your engine—from accelerating chart reviews to identifying coding opportunities in…
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The 2025 CMS D-SNP Revolution
CMS’s 2025–2030 regulatory updates to Dual-Eligible Special Needs Plans (D-SNPs) represent the most comprehensive reforms in Medicare-Medicaid integration history. These changes fundamentally reshape how health plans serve dual-eligible populations, demanding…
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Google backtracks on an internal health policy that required employees to allow a third-party AI tool from startup Nayya review their personal data when enrolling in health benefits. Nayya’s tool asks health and lifestyle…
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The Alarming Scale of Unnecessary Spine Surgeries
A groundbreaking analysis by the Lown Institute has revealed a disturbing trend in American healthcare: hospitals performed over 200,000 unnecessary back surgeries on older adults over a three-year…
Democrats Demand Action on Telehealth Services
Two influential House Democrats are mounting significant pressure on the Department of Health and Human Services (HHS) to immediately reinstate telehealth services, leveling serious accusations that the administration deliberately…
The Stark Reality of Outdated Kidney Care
Imagine receiving a diagnosis of a life-threatening illness—only to discover that your physician is restricted to treatments and medical tools from the early 2000s, despite the existence of…
The US federal government shutdown continues, and with it, the loss of payment for telehealth visits for Medicare beneficiaries.
I reached out to a few of my CMIO friends to understand how their systems…
