Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
The state is accusing the insurer of colluding with the broader Blue Cross Blue Shield network to stifle competition and control prices. BCBSM denies the allegations.
The hack, which was revealed earlier this year in a report from Bleeping Computer, is said to have been limited to a legacy server. Oracle denied its cloud environment had been compromised.
Independence Blue Cross, the largest medical insurance provider in the Philadelphia area, does not admit to wrongdoing. It was accused in a lawsuit backed by the U.S. Department of Justice of misrepresenting the severity of patient illnesses to juice risk-adjusted Medicare payments.
With its $350M in new funding, EliseAI said it plans to build out its technology and sales force. It currently works with specialty provider groups to automate practice operations such as scheduling and insurance verification.
Pennant and BrightSpring Health Services have agreed to purchase some healthcare businesses from UnitedHealth and Amedisys. However, it remains unclear whether this will be enough for the DOJ to drop its lawsuit blocking the merger.
Deerfield Management released details on its latest Healthcare Innovations Fund program, promising to finance “promising therapeutics” and “elevating emerging technologies," including artificial intelligence.
In a lawsuit, plaintiffs allege the company changed course from a long-standing policy of denying medical claims, hiding from investors its impact on profits. The insurer denies any wrongdoing and vowed to defend itself in court.
If President Trump initiates a 25% tariff against pharmaceuticals imported from Ireland, it might impact the price for X-ray iodine contrast agents in the U.S. depending what rules are put in place.
Bloomberg writes about a company, Quick Health, run by a former comedy writer, who through a loophole in the law is accused of "hiring" members for fake jobs to enroll them in junk insurance policies.
Five Tenet Healthcare hospitals are suing the Leapfrog Group, accusing the organization of pressuring hospitals to share internal data in exchange for higher scores in its annual safety rankings. The watchdog outright denies the claim.
