Medicaid is a lifeline for roughly 84.5 million people across the U.S., yet access to that safety net still depends on state lines. Ten states—Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—continue to reject the Affordable Care Act (ACA) expansion, leaving an estimated 1.4 million adults in the infamous coverage gap. This category includes individuals whose earnings are too high for traditional Medicaid but still below the poverty level
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Why Healthcare Organizations are Turning to Managed Service Providers (MSPs)
For some employers, successfully implementing software can feel like a sports team clinching a playoff spot after a grueling season—relief followed by high-fives. But no matter how many bona fide improvements the new software delivers a healthcare organization, challenges inevitably come. The hurdles range from short-term ones, like generating custom reports (beyond the templates that are part of the package), to longer-term concerns, such as replacing the systems’ trained administrators who
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Stop Osteoporosis: A Guide to Preventing Bone Density Loss After Menopause
Osteoporosis is often seen as an inevitable part of aging, especially for postmenopausal women. Many of us grew up with the image of the little old lady, hunched over by kyphosis walking gingerly with a cane. We know older women have to be careful when walking, because a simple trip can cause a life-threatening fracture. We accepted, and even expected, that this was part of the normal and natural age progression for women.
Now is the time to think differently. Menopause may be the end of a
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Data Silos and Patient Safety: Why Connected Tech is the Unused Key to Better Care
In today’s fast-paced healthcare environment, disconnected systems can be as dangerous as delayed diagnoses. The healthcare industry currently generates more data than any other sector, but up to 97% of this data goes unused due to siloed operations. The inability to access and share data across departments and systems has reverberating effects across healthcare organizations, impacting workforce efficiency, economic margins and patient safety.
Disconnection within health systems goes beyond
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How Digital Therapeutics Are Reshaping Chronic Care for the Better
Key Takeaways:
Chronic diseases are a major health and financial burden in the U.S., yet current care models remain outdated, reactive, and fragmented.Digital therapeutics (DTx) offer personalized, clinically validated, software-based interventions that provide continuous, real-time support and monitoring for chronic conditions.DTx addresses key failures in traditional care through behavioral reinforcement, AI-driven personalization, and integration with clinical workflows.Despite
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Data-Driven VBC: How Tech and AI Are Transforming Value-Based Care
The transition from fee-for-service to value-based care (VBC) puts continued pressure on the healthcare industry, especially as organizations push to remain relevant in a competitive environment while improving patient outcomes. The primary goal of VBC is to enhance clinical results and reduce overall healthcare costs, aligning care delivery with the evolving expectations of payers and patients. Learning to utilize comprehensive, real-time, and actionable data from advanced technology will fully
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Ransomware in RCM: Why Your Billing System Is an Overlooked Cybersecurity Risk
When a major healthcare payment processor was hit by a ransomware attack in early 2024, medical practices across the country were thrown into chaos. Routine billing processes, like eligibility checks, claims submissions, and payments, all ground to a halt. Some providers waited weeks to get paid. Others struggled to reassure anxious patients amid financial uncertainty. For small and midsize practices, the disruption wasn’t just inconvenient; it was existential.
The incident exposed an
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Modernizing Medicare Advantage Translations: How AI Streamlines Compliance for Health Payers
For healthcare payers offering Medicare Advantage and Dual Special Needs Plans (D-SNPs), the translation of member-facing materials is a costly, complex and high-stakes process. Translation requirements place an enormous burden on payers and, yet, it is critical for a positive member experience and accessibility in the U.S., where nearly 68 million people speak a language other than English at home.
The Centers for Medicare & Medicaid Services (CMS) mandates that materials such as Annual
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Beyond the Black Box: Why Health Plans Must Redesign Utilization Management for Transparency
For too long, utilization management (UM) has been the most painful source of abrasion between health plans and healthcare providers.
Care decisions are too often made by third-party vendors with opaque regression algorithms trained on old data. Providers are left wondering why medically necessary care is delayed—or denied. And patients, caught in the middle, suffer the consequences. What was intended as a validation of medical necessity has become a byword for inefficiency, and a root of
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MedTech M&A Surges in 2025: Why Startups Are Now Ripe for Acquisition
After a few mixed years in medical technology (MedTech) mergers and acquisition (M&A) activity, 2025 is shaping up to be a landmark year, particularly among cash-rich medical device strategics. In Q1 2025, there were 57 MedTech M&A transactions totaling $9.2 billion, compared to 62 deals worth $2.7 billion in Q1 2024, according to J.P. Morgan’s MedTech sector report.
First quarter venture capital (VC)
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