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Population Health Management (PHM) in Healthcare | News, Analysis, Insights - HIT Consultant

Beyond Reactivity: Integrating AI-Driven Home Safety for Aging in Place

by Evan Schwartz, CEO of Aloe Care Health 12/31/2025 Leave a Comment

The $100B Fall: Why CMS is Betting on AI Ambient Sensing to Fix Aging at Home

Aging in America isn’t a niche issue—it’s a seismic shift. Within five years, one in five Americans will be 65 or older. By 2034, older adults will outnumber children for the first time in U.S. history.1  This demographic flip is already reshaping households, businesses, and public policy. One of the most urgent—and solvable—challenges is housing safety, particularly falls. Nearly 90% of older adults want to remain in their homes as they age.2  Yet, fewer than 10% of U.S. homes are
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The MAHA Paradox: How Medical Device Tariffs Undermine “Make America Healthy Again

by Kinsey Fabrizio, President, Consumer Technology Association 12/31/2025 Leave a Comment

The MAHA Paradox: How Medical Device Tariffs Undermine "Make America Healthy Again

The Trump Administration’s Make America Healthy Again agenda recognizes a simple truth: the best way to improve our health is to empower people to understand and help manage their own care. Affordable medical devices make that possible. Every day, Americans use this technology to check their blood pressure, track sleep, monitor heart rhythms, manage hearing loss, and more. These devices bring care into our homes, extend the reach of doctors, and help millions of people stay healthy
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CMS Launches $50B in Awards to Strengthen Rural Health in All 50 States

by Fred Pennic 12/29/2025 Leave a Comment

CMS Launches New Oversight Initiative to Verify Medicaid and CHIP Eligibility

What You Should Know:  - The Centers for Medicare & Medicaid Services (CMS) is deploying a massive $50 billion investment across all 50 states to overhaul the nation's rural healthcare infrastructure starting in 2026.  - Under the guidance of HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz, the program prioritizes not just workforce expansion, but a significant technological shift toward AI adoption, cybersecurity resilience, and "food-as-medicine"
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Surviving the One Big Beautiful Bill Act: Technology Strategies for Safety-Net Providers Facing Medicaid Cuts

by Jeff Brandes, President and CEO of Azara Healthcare 12/29/2025 Leave a Comment

Surviving the One Big Beautiful Bill Act: Technology Strategies for Safety-Net Providers Facing Medicaid Cuts

Financial challenges are not new to healthcare. A perfect storm of converging trends has left many organizations operating within razor-thin margins in recent years.  For safety-net providers, the latest financial uncertainties introduced by the One Big Beautiful Bill Act present yet another hurdle. Many financial executives may fear making the wrong move and choose to “freeze” in response to Medicaid funding cuts that will equate to nearly $800 million.  Yet inaction is likely
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Advanced Primary Care 2026: Top 6 Investments for Health Systems According to Harvard Medical School

by Fred Pennic 12/24/2025 Leave a Comment

Advanced Primary Care 2026: Top 6 Investments for Health Systems According to Harvard Medical School

What You Should Know - Harvard Medical School’s Center for Primary Care has released a comprehensive "Primary Care Investment Guide," providing the first evidence-based roadmap for deploying capital into team-based care models. - The report identifies six critical "Advanced Primary Care" (APC) services—including behavioral health integration and e-consults—that demonstrate measurable ROI through reduced hospitalizations and improved equity.  - With the U.S. spending only 4.6% of
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CMS Launches WISeR Model: New Medicare Prior Authorization Rules Start Jan. 1

by Gregg Killoren, General Counsel at Xsolis 12/23/2025 Leave a Comment

CMS Launches WISeR Model: New Medicare Prior Authorization Rules Start Jan. 1

Earlier this year the Centers for Medicare and Medicaid Services introduced the "Wasteful and Inappropriate Service Reduction" model, a series of prior authorization requirements designed to ensure timely and appropriate Medicare payment for select items and services in six states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) that take effect Jan. 1.  As part of the “WISeR” requirements, CMS selected tech vendors to implement enhanced technological models to
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Cornell Survey: Experts Warn HSA Conversion and Small Premiums Threaten ACA Affordability

by Fred Pennic 12/23/2025 Leave a Comment

Cornell Survey: Experts Warn HSA Conversion and Small Premiums Threaten ACA Affordability

What You Should Know:  - A new survey from the Cornell Health Policy Center reveals that 70% of health policy scholars believe converting ACA subsidies into Health Savings Accounts (HSAs) would worsen affordability for enrollees. - Additionally, 81% of experts agree that ending automatic renewals—a policy slated for 2028 under the "One Big Beautiful Bill Act"—will substantially reduce Marketplace enrollment. These findings come as policymakers scramble to find alternatives to enhanced
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Why Rural Health Transformation Must Include Maternal Health

by Anish Sebastian, CEO and co-founder of Babyscripts 12/22/2025 Leave a Comment

ACOG Declares Telehealth an “Ethical Imperative” for Obstetric Care

Congress’ most recent budget reconciliation bill included controversial cuts to Medicaid spending. The legislation slashed hundreds of billions of dollars from the program over the next decade, a move that is likely to disproportionately affect rural hospitals and safety-net providers. To offset the cuts, lawmakers introduced the $50 billion Rural Health Transformation Program (RHTP), a five-year initiative (2026-30) meant to
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Prenatal Compliance: Solving SDOH Needs Builds Trust with Moms

by Lauren Barca, MHA, RN, BSN, VP of Quality of 86Borders 12/19/2025 Leave a Comment

Pregnancy is one of the most-expensive episodes for insurers, averaging about $19,000 for pregnancy, vaginal delivery and postpartum care, and $26,000 for cesarean births. Compared with other industrialized nations, costs in the U.S. are nearly eight times higher. And what do mothers in the U.S. get in return for this high-priced care? They get the highest death rate per 100,000 live births in the developed world, with 18.6 deaths recorded in 2022, compared with 5.5 deaths per 100,000 in the
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The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

by Fred Pennic 12/12/2025 Leave a Comment

The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags

What You Should Know:  - A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years.  - The "plot twist" indicates that despite operational hurdles and low revenue exposure today, hospital executives view VBC as essential for long-term financial survival. The data
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