More than 75 million people access comprehensive and cost-effective care through Medicaid, including low-income families, older adults, and individuals with disabilities or chronic conditions.
Given the program’s importance in addressing the health needs of vulnerable populations, optimizing the experiences of Medicaid members and providers is critical. How they interact with the program can impact many outcomes, from member access and care utilization to provider participation and
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Transforming Insurance Verification and Authorizations with AI
Across many healthcare organizations, front-office staff face a significant dilemma: patients seeking help only to be told that their health insurance verification and authorization process could take several days or even months. According to a study by the AMA, more than nine in ten physicians recently surveyed said that prior authorization negatively impacts patient clinical outcomes and, often, leads to treatment abandonment.
This issue mainly arises because current, manual insurance
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Advancing Drug Discovery with Quantum Computing and Supercomputer Tech
McKinsey & Company estimates it takes up to 12 years to introduce a new drug to the market – a lengthy timeline comprised of many factors including technology limitations, regulatory requirements, and patient recruitment and retention. Scientific innovation and clinical trials are increasingly complex, generating more data than ever. Researchers are facing difficulties managing the volume and variety of data, turning to artificial intelligence, machine learning and advanced data architecture
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Pharmacogenomic Testing in Mental Health: The Need for a Broader Approach
What if we advised people to wear seatbelts only on certain days or when driving on specific highways? Clearly, this would result in real and avoidable harm. Unfortunately, something similar has happened to millions of patients who underwent pharmacogenomics (PGx) testing to aid in selecting drugs and doses for treating depression or anxiety, tailored to their unique genetics, without considering the broader implications. In mental health treatment, patients often endure multiple therapies
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Bioinformatics: Why Life Sciences Must Adopt Open Science
Today's biomedical research can be complex and time-consuming, as researchers grapple with the challenging task of managing and analyzing ever-growing volumes of complex scientific data. Leveraging advanced bioinformatics tools and techniques is crucial for transforming this data into meaningful insights. Standardization and collaboration within the bioinformatics space is the solution enabling researchers to meet the demands of today. Sharing such analyses and findings across the
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The Impact of Private Equity Consolidation in Healthcare
On a brisk 2023 October morning at St. Elizabeth’s Medical Center in Boston, Sungida Rashid and her husband Nabil held their newborn daughter for the first time. Rashid soon began to experience severe complications, including bleeding of the liver. This normally would be treated with embolization coils; however, the manufacturer had retrieved all coils at the hospital weeks before because Steward hadn't paid its bills. According to a lawsuit filed that same month by the manufacturer,
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The Vital Role of Hybrid Unified Communications in Healthcare Organizations
Hospitals and healthcare clinics are among the most complex technological ecosystems to manage. Staff and patients demand timely, secure, and dependable communication, while administrators often face shrinking budgets and increased regulatory oversight.
Today’s hybrid unified communications (UC) platforms are uniquely positioned to address these challenges. They allow healthcare organizations to optimize their infrastructure and investments while maintaining data security. Modern
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From TikTok to the Frontline: The Unsung Heroes of Healthcare Strike Management
Last summer, Mireya Bustamante, BSN, RN, had more than 51,000 TikTok followers and 4.4 million likes across her videos when she posted a TikTok about her time as a travel nurse. The 35-second clip showed Ms. Bustamante flying into an unspecified city where staff nurses were striking. In the clip, Ms. Bustamante said, "Strike contracts are a pretty quick turnaround, so you must be ready to go. You also have to be extremely adaptable and flexible."
A quick, seemingly innocuous video that you
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How Real-Time Location Systems (RTLS) Can Revitalize Healthcare Teams
The safety and well-being of patients and staff have become one of the main challenges in the healthcare industry, as high-quality patient care depends on variables such as organizational processes, system implementation, accuracy of data insights, and support for health professionals. Studies have shown that these factors significantly influence patient safety and outcomes. The industry has been striving to recognize and address these challenges in recent years by pursuing the Triple Aim (the
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The Evolution of Prenatal Monitoring: How AI and Remote Monitoring Can Improve the Provision of Care
Prenatal monitoring technology has advanced considerably over the last decade. High-resolution sonograms now offer unprecedented clarity, enabling detailed insights into fetal development. Meanwhile, innovations have transformed previously cumbersome and uncomfortable equipment into more portable and user-friendly devices, enhancing accessibility and patient comfort. However, for essential insights into fetal health and development, clinicians still rely primarily on legacy in-clinic systems and
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