In recent years, payers have increasingly turned to artificial intelligence (AI) as a tool to streamline claims processing, accelerating the deployment of rules related to prior authorizations and medical-necessity assessments. Providers believe this has been a key driver behind a corresponding surge in claims denials, as well funded payers leverage technology to rapidly render these determinations and send them back to hospitals.
This trend has providers looking to respond with a
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The Role of AI-Enabled Pathology in Enhancing Patient Care
There’s no doubt that cancer screening, early detection, and swift intervention are invaluable for improving patients’ health outcomes. In this process, once a clinician has determined a need for a tissue biopsy after detecting an abnormality, diagnostic accuracy and efficiency become crucial factors in the treatment journey.
We’ve seen great advancements when it comes to screening and targeted therapies. However, these treatments cannot occur without an accurate and timely diagnosis.
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New ASCVD Risk Assessment G-Codes Can Enhance Preventive Care with Integrated Solutions
The Centers for Medicare and Medicaid Services (CMS) update to the 2025 Physician Fee Schedule includes a measure that holds significant promise for advancing cardiovascular disease management. The initiative introduces G-codes for atherosclerotic cardiovascular disease (ASCVD) risk assessment and management. When implemented, the changes could greatly increase use of the ASCVD risk assessment in primary care, which has previously faced several barriers to adoption including insufficient time,
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In the Push to Close Nurse Staffing Gaps, the Math Points to Diversifying Support
Gaps in the nursing workforce remain elevated, with an 18.4% hospital turnover rate for registered nurses and an RN vacancy rate of 9.9%, a recent report shows. In fact, more than half of hospitals face nurse vacancy rates of 10% or higher.
It’s a sign of the need to seriously evaluate how we are filling nursing shifts, rather than clinging to a full-time-only model for support or expecting part-time nurses to work exclusively for the hospital or health system.
The Business Case for an
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Addressing Bias in Healthcare AI: A Guide for Developers and Clinicians
The promise of AI is greater efficiency in solving complex problems. But with that promise comes the responsibility of understanding and applying
governance, ethical, and reliability principles. Therefore, developing a responsible approach to developing and deploying artificial intelligence (AI) in a safe, trustworthy, and ethical fashion is essential. As 94% of IT leaders believe more attention should be paid to responsible AI development, the healthcare industry must devise strategies
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The Role of Digitally Savvy Clinical Leadership Ready for the Future in Healthcare
As technological innovations, AI and challenges in healthcare continue to grow, it’s imperative for healthcare leaders – especially clinical ones – to be digitally competent and step into the forefront of change with skills and expertise to support a better future. Not only do they need to be efficient in use of existing technology to streamline operations and support frontline workers, but they also need to be open to new technologies in their workplaces to advance the industry, to pressure
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How Pharma Can Enhance Infusion Clinic Operations and Patient Care
Infusion Clinics (ICs) face a delicate balancing act. They must strive for operational excellence while simultaneously navigating the realities of competition, patient care challenges, and compliance requirements. It’s a difficult challenge, and as ICs adapt to evolving demands, there’s a growing need for pharmaceutical manufacturers to step up with tailored support.
From streamlining medication access to advocating for policy changes, manufacturers can significantly impact how ICs
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Breaking Down Barriers to Healthcare Interoperability in 2025
Healthcare interoperability remains one of the most critical and challenging aspects of the healthcare industry. Despite significant progress over the past few years, achieving full interoperability is still a work in progress.
How can we break down the barriers that prevent us from achieving full interoperability? I know what you're thinking. Aren't we done with this yet? Haven't we already achieved interoperability? Spoiler alert - there is more to do and we're not there
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Hospital-at-Home Programs: Learning from Global Successes
The concept of Hospital-at-Home (HaH), first introduced in the 1990s and not widely used, gained renewed attention and increased deployment across the United States during the pandemic. As hospitals faced overwhelming patient demand, the Centers for Medicare & Medicaid Services (CMS) introduced a temporary waiver program, reimbursing hospitals for treating acutely ill patients in their homes when they would otherwise be treated in a hospital.
Since then, over 300 hospitals have been
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7 Behavioral Health Technology Trends to Watch in 2025
The convergence of technology and behavioral health has seen rapid acceleration in recent years. Between the growing appeal of digital therapeutic apps, the evolution of clinical note-taking tools, and the growing ability of AI tools to meet patients’ and providers’ needs, many of these trends are already in motion.
Here’s what to watch for on these frontiers and more in 2025:
Continued adoption of clinical note-taking tools. Technology is often met with distrust among practitioners. In
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