Doctors aren’t just healers—they’re involuntary lenders. Every time a physician treats a patient, they’re fronting the cost of care and hoping to get reimbursed. If the insurer underpays or denies the claim, the financial burden falls on the patient. And if the patient can’t pay? The doctor eats the loss.
No other profession operates like this. Imagine a contractor building a house and only finding out months later whether they’ll be paid, and how much. That’s how American healthcare works.
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Population Health Management (PHM) in Healthcare | News, Analysis, Insights - HIT Consultant
Transcarent Completes Merger With Accolade
What You Should Know:
- Transcarent today announced the successful completion of its merger with Accolade, a market leader in health advocacy, expert medical opinion, and virtual primary care.
- The newly combined organization, operating under the Transcarent name, now serves an impressive 20 million lives across more than 1,700 employer and health plan clients. This scale uniquely positions the company to address over 80 percent of an employer's healthcare spending by
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MedeAnalytics, Socially Determined, and Mathematica Join Forces to Quantify the Impact of Social Determinants of Health
What You Should Know:
- MedeAnalytics, a healthcare enterprise data enrichment platform and analytics software-as-a-service (SaaS) provider, today announced a collaboration with Socially Determined and Mathematica.
- The strategic partnership aims to revolutionize the way the healthcare industry measures, validates, and understands the financial impact of interventions targeting social determinants of health (SDOH).
Transform Social Determinants of Health
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5 Value-Based Care Strategies to Control Patient Care Costs
The staggering reality that health care could soon account for one fifth of all domestic spending has put a bull’s eye on health care cost control. Is your ACO, health system, or physician organization ready to manage the coming congressional budget cuts? The only effective way to tackle Total Costs of Patient Care (TCoC) without cutting services is through a curated value-based care approach. Here are the fundamentals you need to know and five strategic steps to
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Rural America Loses Independent Physicians and Practices at Alarming Rate, Report Finds
What You Should Know:
- A new report commissioned by the Physicians Advocacy Institute (PAI) and conducted by Avalere reveals a significant decline in the number of independent physicians and medical practices in rural areas of the United States between January 2019 and January 2024.
- The report raises concerns about reduced access to care, rising costs, and a decline in care quality for rural communities.
Report Background/Methodology
The analysis used data from the
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Modivcare & Aetna Deploy Higi Stations in Illinois Communities
What You Should Know:
- Illinoisans now have easy access to user friendly enhanced health stations through a collaboration between Modivcare Inc. (the “Company” or “Modivcare”) (Nasdaq: MODV), a healthcare services company integrating technology into personalized care experiences, focused on improving health outcomes, and Aetna Better Health® of Illinois, a CVS Health® company.
- The Modivcare Higi Stations offer self-service health information and digital navigation, as well as
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State of Ohio Taps Bamboo Health to Reduce Fatal Drug Overdoses
What You Should Know:
- In a proactive effort to combat the ongoing opioid epidemic and reduce drug overdose fatalities, Bamboo Health™, a leader in Real-Time Care Intelligence™, is partnering with the State of Ohio to strengthen its prescription drug monitoring system, the Ohio Automated Rx Reporting System (OARRS).
- The strategic collaboration will introduce a critical new feature, OD Insights™, designed to alert healthcare providers within their existing workflows if a
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Quantum Health Launches New GLP-1 Solution for Employers
What You Should Know:
- Quantum Health, a provider of healthcare navigation and care coordination, has announced the expansion of its Premier Pharmacy platform to offer self-insured employers a new GLP-1 weight management solution.
- The GLP-1 offering, powered by Vida Health, aims to optimize prescribing patterns, improve clinical outcomes, and provide comprehensive member support for weight loss.
Growing Demand for GLP-1 Medications
The need for effective weight
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FarmboxRx Launches Drivers Health Platform to Tackle Social Determinants of Health
What You Should Know:
- FarmboxRx, a pioneer in utilizing fresh produce as a covered health intervention, has unveiled Drivers Health (DH), a comprehensive social needs solutions platform.
- The platform is designed to address the multifaceted social needs of healthcare members, providing a tailored, omnichannel experience that enhances benefit engagement and overall well-being.
Drivers Health Empowers Members Across Vulnerable Populations
Drivers Health emerges as a critical
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5 Million Adults Could Lose Medicaid Under Work Requirements in 2026
What You Should Know:
- Proposed work requirements for Medicaid could lead to millions of Americans losing their health insurance, according to a new analysis by the Urban Institute with support from the Robert Wood Johnson Foundation.
- The analysis projects that 4.6 to 5.2 million adults living in states that expanded Medicaid could lose their coverage in 2026 if work requirements are enacted.
Key Findings
Researchers caution that if work requirements were applied to
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