Payment integrity (PI) is an essential component of the healthcare ecosystem, ensuring that payers correctly process claims and prevent financial losses due to errors, fraud, or misinterpretations of contracts. In today’s environment, major healthcare payers face substantial financial challenges, which can lead to layoffs and increased scrutiny of how money flows through the system. The demand for highly advanced, balanced PI solutions has never been greater.
Getting PI right has never
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Why Incremental Change is Killing Healthcare Transformation
Fifteen years ago, I made a conscious decision to enter the healthcare sector. At 34, I had options, but I wanted a career that would challenge me intellectually—so much so that I once told people I wanted my “brain to hurt.” I wasn’t naïve about the industry’s complexities, but I didn’t anticipate how much it would also hurt my heart.
A decade and a half later, after working across multiple roles in healthcare, I can confidently say the industry met my wish for intellectual challenge. What I
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How E-Prescribing Improves Opioid Safety and PDMP Compliance in Healthcare
According to recent CDC data, opioids remain the driving force behind the vast majority of U.S. drug overdose deaths. While prescription rates have declined over the past several years, opioid-related overdoses have actually risen again since 2024, underscoring that the crisis has not eased, but shifted. Today’s challenge isn’t just preventing overprescribing; it’s navigating a more complex risk environment where illicit drugs, prescription misuse, and patient access needs intersect.
How
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HR Strategies for Engaging the ‘Deskless’ Healthcare Workforce
The average healthcare worker’s day is a whirlwind of patient care, quick decisions, and teamwork, rarely with a moment to sit, let alone check emails or attend a meeting. While office-based colleagues catch up on company news over coffee, front-line workers are running from room to room, often the last to hear about policy changes or organizational updates.
This is the reality for millions of frontline healthcare workers. Their dedication keeps hospitals running and patients
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Why Poor EHR Integration Fuels Clinician Burnout and Financial Loss
For decades, healthcare leaders and physicians have been promised that digital tools would streamline operations and boost revenue. Yet, history has repeatedly shown the opposite: documentation inefficiencies and fragmented tech stacks have slowed practices, burdened clinicians and chipped away at financial margins. What began as an effort to modernize recordkeeping too often left providers drowning in siloed systems that robbed them of both time and revenue.
Despite massive investments in
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AI as the New Primary Care Extender: A Solution to Physician Shortages
If the COVID-19 pandemic taught us anything, it is this: primary care physicians are the backbone of a functioning health system. Yet, in the United States, the supply of those physicians is dwindling at precisely the moment demand is peaking. The Association of American Medical Colleges (AAMC) for example, projects a shortage of up to 124,000 physicians by 2034, including at least 17,800 in primary care. For patients, that shortage translates into longer wait times, rushed
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How AI Is Poised to Cut Lung Cancer Mortality by Accelerating Early Detection
With lung cancer being the leading cause of cancer-related deaths worldwide, advancements in AI-powered healthcare technology are offering newfound hope. Over the span of the next few decades, AI is poised to revolutionize lung cancer outcomes by detecting cancer at its earliest stages. By improving upon and providing proactive detection by accelerating the identification of high-risk patients, this technology has the capability to dramatically lower mortality rates.
A major milestone
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RTLS for the CIO: How Scalable Location Platforms Drive Operational Excellence and Reduce Cost
Healthcare facilities today face unprecedented challenges: from rising expectations for a seamless digital experience to staffing shortages, safety concerns, increasing operational costs, and mounting pressure to improve efficiency and outcomes through timely, coordinated care. In response, many organizations are turning to proven technologies like Real-Time Location Systems (RTLS) to drive efficiency, enhance safety, and improve patient care.
Even so, not all location technologies and
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Why Virtual Weight Management Needs to Be Outcomes-Driven and Device-Enabled
As payers and health systems seek scalable solutions to address obesity, the conversation is shifting from access to accountability. Virtual weight management programs have emerged as a critical tool for expanding reach, but to deliver real value, these programs must prove their value ahead of the competition in an increasingly competitive market. This proof needs to be shown in both ROI and patient and population outcomes.
The obesity epidemic is well documented, but as recent research
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Cybersecurity Challenges in AI-Driven Pharmaceutical Manufacturing: Lessons from the Frontlines
The pharmaceutical industry is undergoing a digital transformation like never before. Emerging technologies such as artificial intelligence, the internet of things, and real-time analytics have revolutionized manufacturing. Predictive maintenance, intelligent batch scheduling, and machine learning enhanced inspections have created a modern production floor that is smarter, faster, and more connected.
This transformation, however, comes with an underestimated cost: cybersecurity risk.
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