insurance
publication date
Innovation
Predictive AI Helps Providers Plan Patient Care
Health systems like West Tennessee Healthcare are using AI platforms that can map out a patient?s predicted stay, allowing clinicians...
Payer
Will 2025 Mark a Turning Point for Medicare Advantage?
When is growth not enough to keep payers happy?
Payer
The Many Faces of UM: The Next Two Decades
Utilization management has the power to perform many jobs. Will it?
Payer
Medicare Advantage in 2024: Enrollment Update and Key Trends
The growth in Medicare Advantage enrollment is due to a number of factors, including the availability of plans that charge...
Payer
The Many Faces of UM: A Little History
The definition of UM has changed. Some of the results remain stubbornly the same (and unclear).
Payer
Blue Shield of California Embraces Digital Health Innovation to Improve Member Outcomes
A digital health management platform is making waves in diabetes care and could help members with other care needs.
Payer
CBO: Uninsured Rates Projected to Rise Through 2034
After years of coverage growth, the very factors that are protecting more Americans could reverse progress.
Payer
23 Million Unenrolled: 11 Insights from the Medicaid Unwinding
New Kaiser Family Foundation research reports state challenges and some successes despite mass disenrollment.
Payer
Socially Determined and Mathematica Partner to Target Social Risk for Government Organizations
The partnership seeks to highlight the impact of social determinants of health on costs and outcomes.
Technology
Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors
Deloitte pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid....
Payer
Biden Administration Advances Plan To Remove Medical Debt From Credit Scores
Tens of millions of Americans are struggling with medical debt. The Biden Administration is moving forward with a plan to...
Payer
How Payers Can Leverage Data in Contract Negotiations
Accurate payer-provider data exchange is critical to negotiations. If one party does not have plentiful, accurate data, it can hurt...