With more than 20 years of experience at a major health insurance company, I’ve seen firsthand how challenging provider data management can be. I’ve worked with teams reconciling files from delegated groups, fielded calls from frustrated providers, and navigated compliance pitfalls that can quickly become operational headaches. But the stakes have never been higher than they are now under the No Surprises Act (NSA).
For years, maintaining an accurate provider directory was considered a best
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Health IT | News, Analysis, Insights - HIT Consultant
Elsevier’s Clinician of the Future 2025 Report: AI’s Rapid Ascent in Healthcare Amidst Clinician Pressures
What You Should Know:
- The 4th annual Elsevier Clinician of the Future report reveals a remarkable acceleration in the adoption and impact of Artificial Intelligence (AI) in healthcare.
- Based on a global survey of over 2,000 clinicians, the report highlights AI's growing role in addressing persistent challenges like clinician burnout, increasing patient demand, and fragmented care, while also shedding light on evolving perceptions and regional differences.
Current State
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Ultrahuman Launches Blood Vision Nationwide, Enhances Health Tracking with Wearable Data Integration
What You Should Know:
- Ultrahuman, the pioneering health optimization company behind the Ultrahuman Ring and M1 (an advanced Continuous Glucose Monitoring platform), today announced the nationwide expansion of Blood Vision, now available across 48 U.S. states.
- Unlike traditional blood testing services that offer static snapshots, Blood Vision combines deep biomarker analysis with real-time wearable data to create the most advanced consumer-facing system for longitudinal health
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Boost Medicare Star Ratings: A Strategic Game Plan for Health Plans
As they navigate complex times, health insurers have their eye on two important financial indicators. And both are moving in the wrong direction. Costs are on the rise while Medicare Star Ratings are on the decline.
Separate but related, the two trends converge on the same idea: health plans need to enable higher quality care at a lower price.
If it sounds like a Herculean feat, that’s because it is. But some health plans are making it happen.
While some of the cost pressures—for
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Fruit Street Health Cleared: SEC Investigation Concludes with No Action
What You Should Know:
- Fruit Street Health announced that it has received a letter from the Securities and Exchange Commission ("SEC") confirming the conclusion of the SEC's investigation into the company. The letter states that the SEC enforcement staff does not intend to recommend any action by the SEC against Fruit Street Health.
- This announcement allows Fruit Street Health to continue its focus on its public benefit mission: serving the 1 in 3 Americans with prediabetes and
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evolvedMD Secures $34M to Expand Integrated Behavioral Health Care Nationwide
What You Should Know:
- evolvedMD, a Collaborative Care Management (CoCM) provider, announced the close of its $34M Series B investment round, led by Sustainable Investing at Goldman Sachs Alternatives. Existing investors Conductive Ventures, FCA Venture Partners, Healthworx Ventures, Tectonic Ventures, and Waterline Ventures also participated in the round.
- The funding will be used to accelerate evolvedMD's mission to increase behavioral health care availability and expand
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CMS Proposes 2026 Physician Fee Schedule Rule: Boosting Primary Care, Cutting Waste, and Modernizing Payments
What You Should Know:
- The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule for the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS).
- The proposal aims to increase quality care for Medicare recipients while significantly reducing unnecessary spending. Key initiatives include advancing primary care management through new quality measures, reducing waste in skin substitute spending, and introducing a new payment model focused on
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Beyond Patient-Centric: The Rise of Evidence-Based, Content-Centric Care
he past decade has seen healthcare undergo a paradigm shift. Walking into a treatment room today, the dynamic with patients is fundamentally different from even a few years ago. No longer satisfied with passively receiving care, patients – in particular, younger generations like Gen Z – increasingly want a seat at the table. They want to be active, informed participants in all aspects of their health care. And the data backs this up. According to McKinsey, only 42% of Gen Z depend on doctors for
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Omega Healthcare Expands Microsoft Collaboration, Launches 20+ AI Solutions to Transform Revenue Cycle Management
What You Should Know:
- Omega Healthcare, a provider of technology-enabled Revenue Cycle Management (RCM) services, today announced an expanded collaboration with Microsoft.
- Through the integration of Microsoft Azure's cutting-edge AI models via Azure AI Foundry and the company's proprietary Omega Digital Platform (ODP), Omega Healthcare has launched more than 20 generative and agentic AI solutions designed to enhance healthcare organizations' revenue cycle operations and
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FTC Penalizes NextMed $150k for Deceptive Weight-Loss Claims
What You Should Know:
- The Federal Trade Commission (FTC) has reached a settlement with Southern Health Solutions, Inc., operating as Next Medical and NextMed, and its founders Robert Epstein and CEO Frank Leonardo III.
- The FTC's charges allege the telemedicine company used deceptive cost and weight loss claims, fake reviews, and undisclosed terms to lure consumers into their weight-loss membership programs.
Deceptive Weight-Loss Claims and Hidden Fees
According
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