HEALTHCARE NEWS

The Practice Economics Crisis: Why Your Bottom Line Doesn't Match Your Paycheck How rising operational costs are quietly destroying physician practice viability Your salary went up 3.7% last year, according to Doximity's 2025 Physician Compensation Report. Meanwhile, Medicare cut your reim...

No Roads, No Revolution: Why Healthcare’s Broken Data Infrastructure Is Undermining AI Innovation In the age of generative models and multimodal clinical assistants, healthcare AI is often heralded as the next frontier—one poised to solve physician burnout, accelerate diagnosis, and...

NYRx ePA Launch: Transforming Prior Authorization for New York MedicaidThe Dawn of Streamlined Prior Authorization in New York MedicaidHealthcare providers in New York are about to experience a significant shift in how they handle prior authorization requests. Starting July 15, 2025, NYRx, New York'...

The Political Strategy Behind Delayed Healthcare Cuts The recent passage of President Trump's tax and spending bill reveals a sophisticated political strategy that healthcare policy experts have seen before: backloading controversial cuts to minimize immediate electoral consequences. With nearl...

CVS Caremark $95 Million Medicare Fraud Settlement: A Deep Dive into PBM Pricing Practices and Systemic Healthcare Cost Manipulation  The recent $95 million settlement against CVS Caremark represents far more than a single company's misconduct—it exposes the systemic vulnerabilities ...

The AI Prior Authorization Crisis: When Algorithms Override Medical Judgment The healthcare industry stands at a critical crossroads. While artificial intelligence promises to revolutionize medical care, its current deployment in insurance prior authorization systems has created an unprecedente...

The Billing Revolution: How Value-Based Care is Reshaping the Future of Medical Billing The traditional medical billing office—with its towers of paper claims, denial follow-up spreadsheets, and revenue-per-service mentality—is becoming a relic of healthcare's past. In its place, a ...

CMS Bolsters Medicare Advantage Audits to Combat Overbilling and Ensure Accountability The Stakes of Medicare Advantage Oversight Medicare Advantage, a program that allows private insurers to administer Medicare benefits, has grown exponentially over the past two decades. As of 2025, nearl...

UnitedHealth Group Under Scrutiny: What Recent Investigations and Industry Challenges Mean for Healthcare Providers UnitedHealth Group, one of the most powerful forces in the U.S. healthcare system, is currently facing a perfect storm of challenges — federal investigations, leadership cha...

Communication Strategies to Overcome Prior Authorization Tech Hurdles  Prior authorization (PA) stands out as a persistent challenge, bogging down providers with administrative complexities and delaying patient care. While technology offers promising solutions, barriers such as lack of sta...

Republican Lawmakers Demand CMMI Prioritize Cost Savings, Transparency, and Rural Healthcare Republican lawmakers on the House Ways and Means Committee have issued a forceful call for the Center for Medicare and Medicaid Innovation (CMMI) to realign its priorities under the Trump administration...

Telehealth’s Vital Role in Medicaid  As healthcare evolves in the post-COVID era, telehealth has emerged as a critical lifeline for millions of Americans, particularly those enrolled in Medicaid. A groundbreaking study from the University of Michigan, published on April 16, 2025, in ...

Medicaid in 2025: Policy Shifts, Challenges, and Strategies for Providers Medicaid stands at a crossroads in 2025, with policy changes poised to reshape healthcare access for millions of Americans. Among the most significant developments is the potential expansion of Medicaid work requirements,...

New Communication Center in Availity Essentials, Aetna  Streamlining Credentialing Communication for Healthcare Providers Aetna's recent announcement about the addition of a new Communication Center in Availity Essentials marks a significant step forward in provider enrollment and net...

The Debate Over Medicaid Work Requirements  Medicaid, a cornerstone of the American healthcare system, has long served as a safety net for low-income individuals and families. However, with rising enrollment and increasing federal expenditures, policymakers have continuously debated how to...