What You Should Know:
- A U.S. District Court judge in the Southern District of New York, Judge Naomi Buchwald, has allowed Core Antitrust Claims against Epic to proceed.
- The ruling found that Particle Health, a healthcare data platform, may move forward with its claims that Epic holds a monopoly in the payer platform market with a 90% market share and has engaged in anti-competitive conduct. The ruling marks as the first time an antitrust case against Epic has progressed
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Health IT | News, Analysis, Insights - HIT Consultant
Hello Patient Raises $22.5M to Scale Conversational AI for Patient Communications
What You Should Know:
- Hello Patient, a conversational AI company secures $22.5M in Series A financing led by Scale Venture Partners with participation from 8VC, Bling Capital, Max Ventures, Remus Capital, and FirstLook Partners.
- The Hello Patient platform handles end-to-end patient conversations across voice, text, and chat, helping healthcare practices run leaner, grow faster, and deliver better care. With this new funding, the company plans to continue expanding its product
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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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HealthEdge and UST HealthProof Merge to Modernize Health Plans
What You Should Know:
- HealthEdge and UST HealthProof have announced the successful completion of their merger, following Bain Capital's acquisition of UST HealthProof from UST.
- The combined company will operate as HealthEdge, with its headquarters in Boston. With a reach that touches over 110 million lives in the U.S., HealthEdge is now positioned to empower health plans with modern, AI-enabled technology and services that can lower total costs and improve operational
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MCG Health and Avo Launch AI Assistant to Reduce Hospital Length of Stay
What You Should Know:
- MCG Health, a part of the Hearst Health network, and Avo, a clinician-created AI platform, have launched a new AI assistant designed to tackle the challenge of hospital length of stay (LOS).
- The partnership integrates recovery milestones from MCG's proprietary guidelines directly into electronic health record (EHR) workflows using Avo's new assistant. This tool gives hospitalists and case managers a real-time picture of each patient’s readiness to go
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SoundHound AI Partners with Primary Health Solutions to Deploy AI Patient Engagement Platform
What You Should Know:
- SoundHound AI, Inc., a global leader in voice and conversational AI, has partnered with Primary Health Solutions (PHS) to deploy a new AI-powered patient engagement platform.
- The initiative makes PHS one of the first Federally Qualified Healthcare Centers in the U.S. to use AI Agents to create a more seamless and engaging patient experience.
Denise: Conversational AI Platform
The new conversational AI platform, named "Denise" in honor of a PHS
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TigerConnect Launches Transfer Solution to Modernize Patient Transfers and Discharge
What You Should Know:
- TigerConnect, the leading unified healthcare communications platform, today announced the general availability of TigerConnect Transfer, a purpose-built solution that modernizes how hospitals manage outbound interfacility patient transfers and discharge transport.
- By combining bed sourcing, transport scheduling and communication in a single application, Transfer bridges the gap between hospitals and external agencies to accelerate safe patient movement.
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HHS Announces Crackdown on Information Blocking to Empower Patients and Innovators
What You Should Know:
- The U.S. Department of Health and Human Services (HHS) has announced a new initiative to increase resources dedicated to curbing the practice of "information blocking".
- Secretary Robert F. Kennedy, Jr. has directed HHS to take active enforcement against healthcare entities that restrict patients’ access, exchange, and use of electronic health information.
Empowering Patients and Innovators
The announcement states Information blocking was not
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Reducing Healthcare Waste by Minimizing Reshipments to Clinics
An often-referenced fact is that the U.S. spends more money on healthcare than any other nation. Experts estimate that the cost of waste in the U.S. healthcare system range between $760 billion to $935 billion, about 25% of all spending. One area with strong potential for waste reduction is the minimization of reshipments to clinics. Reshipping medications to clinics is not just a logistical issue—it’s a matter of patient care and, in some cases, saving lives. Clinics frequently report missing
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