By using AI-powered intelligence to shift clinical and coding validation earlier in the healthcare continuum, and unlocking upstream clinical data to inform downstream payment workflows, organizations can proactively prevent errors, reduce downstream churn and friction, and support more predictable, accurate, and timely payments. The post The Next Era of Payment Integrity: Earlier Clinical Validation, True Transparency appeared first on MedCity News .
What matters just as much — if not more — is everything around that number: how customers adopt the product, how sales actually happen, and whether the company is building something that can scale inside a complex, regulated system. The post Revenue Isn’t the Signal: What Early-Stage Health Tech Investors Should Be Watching Instead appeared first on MedCity News .
A consultant who has analyzed healthcare policy over many decades declares that MA is in the middle of a fundamental reset both in terms of market headwinds and federal scrutiny. The post Policy Expert Believes CMS is Taking “Adversial Posture” to Medicare Advantage appeared first on MedCity News .
UnitedHealthcare is exempting rural providers from most prior authorization requirements. The post UnitedHealthcare Expands Rural Healthcare Initiatives, Reduces Prior Auth Requirements appeared first on MedCity News .
OSHA and NIOSH recommend that all hospitals develop comprehensive violence prevention programs. Here are some action items that provide a framework for building a legally defensible program. The post OSHA’s Evolving Approach to Workplace Violence Prevention in Healthcare appeared first on MedCity News .
When patients disengage, preventive care is missed, chronic conditions worsen, care shifts to higher-cost settings such as the emergency department and urgent care, and patients fragment across systems, reducing continuity. The post Stopping Patient Attrition Before it Starts: A Proactive Approach to Healthcare Marketing appeared first on MedCity News .
Himanshu Shah, an activist investor and large shareholder of Novavax, whose stock has plummeted over the years, believes the company should cut costs more aggressively, reduce the size of its board, and do more to prop up its financial performance. But are the criticisms valid? The post Is Shah Capital’s Criticism of Novavax Fair? A Wall Street Analyst Weighs In appeared first on MedCity News .
Obsidian Therapeutics aims to show its TIL cell therapy has advantages over an Iovance Biotherapeutics TIL therapy marketed for treating melanoma. Obsidian’s merger with Galera Therapeutics will give it a public listing and a private placement to support clinical development of the combined company’s cancer drug pipeline. The post Obsidian, Galera Merger Comes With $350M Infusion for Cancer Drug Trials appeared first on MedCity News .
CMS is proposing to make its joint replacement bundled payment model mandatory nationwide. Experts say it is a logical step, but warn that mandatory participation could be challenging for hospitals to implement. The post Expanding the CJR Model Is a Logical Step in VBC, but Implementation Challenges Remain appeared first on MedCity News .
Care delivery doesn’t have to be binary — in-person or virtual, old model or new. It can be adaptive, team-based, and deeply human. The post How Team-Based and Virtual Nursing Models Are Redefining Care Delivery appeared first on MedCity News .
The challenge isn’t whether AI can be used (it already is). It’s whether it can be trusted. And trust in medicine is not something healthcare professionals can afford to get wrong. The post Trust and AI Adoption in Medicine appeared first on MedCity News .
A new report from Trilliant Health finds behavioral health demand has surged since 2018, but workforce shortages and access barriers continue to limit care. The post Behavioral Health Demand Has Increased by 62% Since 2018. What the Industry Needs to Know appeared first on MedCity News .