This spring, the American Medical Association (AMA) and dozens of physician groups sent federal officials a letter detailing how health plans are circumventing the No Surprises Act — through inappropriate cost-shifting, IDR manipulation, depressed QPAs and unpaid awards. For pro-fee…
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Many mental health apps covered by health plans today are built on general-purpose AI — the same models designed to write emails and summarize documents. Those models are trained to be agreeable and validating. In a mental health context, that…
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Most healthcare organizations have a cyber crisis plan. Few have one that holds up when an attack disrupts operations at scale. The gap often comes down to identity infrastructure, the foundational layer that governs access to every critical system. When…
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The U.S. Department of Veterans Affairs delivers more than 127 million healthcare appointments annually while managing a massive, years-long EHR modernization effort. At the same time, clinicians across the system are facing growing documentation demands, workforce shortages and the cognitive…
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Every minute a stroke goes unrecognized, a patient loses an average of 2 million neurons. Yet fewer than 30% of acute ischemic stroke patients are treated within the first hour — when treatment is most effective. The gap isn’t always…
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Every health system was built around one constraint: the scarcity of human expertise. That constraint is lifting, and every leader is feeling the same tension. How do you solve for today’s problems while preparing for a future that looks nothing…
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Healthcare organizations have spent years building digital strategies. A lack of ambition is not the issue. The challenge is that most strategies still don’t translate to the people delivering care. Front-line clinicians are quietly opting out of tools they were…
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Lynwood, Calif.-based Saint Francis Medical Center has the lowest number of hospital return days for heart attack patients in the nation, according to CMS data. The “Unplanned Hospital Visit” database tracks provider data for hospital return days, unplanned readmission and…
No matter how diligently health systems plan, they cannot control the many external factors that create volatility in supply chains for vital healthcare resources. However, health systems can build resiliency into their organizations to mitigate the impact supply chain fluctuations…
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Picture a radiology revenue cycle where prior authorization issues get caught before claims go out, documentation gaps get flagged in real time and denial trends actually inform the next intake conversation. That’s the operating model the strongest radiology RCM teams…
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