What You Should Know:
- Lumeris, a leader in healthcare technology and services announced the formation of a powerful new coalition, the Collaborative for Healthy Rural America (CHRA). The CHRA has b een established to provide an immediate and scalable execution path for state leaders participating in the Rural Health Transformation Program (RHT), administered by the Centers for Medicare & Medicaid Services (CMS).
- The coalition brings together a formidable team of industry
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Population Health Management (PHM) in Healthcare | News, Analysis, Insights - HIT Consultant
Why Value-Based Care Fails to Reward LTPAC Providers Today
The chorus of voices singing the praises of value-based care is growing ever louder. But in LTPAC, it still feels like the system’s asking providers to do more—with less—and faster than ever.
For the past 25 years, financial strategy in long-term and post-acute care has been tied to two things: occupancy and payer mix. Around 70% of residents are covered by Medicaid. The rest—split between Medicare fee-for-service, Medicare Advantage, and private pay—bring in higher rates, especially
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The Invisible Risk Factor: Why Chronic Loneliness Is Sabotaging Chronic Care and Medication Adherence
Connectivity was supposed to bring us closer. Instead, it’s exposing a dangerous gap in our healthcare system. The very tools designed to link us have scaled rapidly, but without addressing one of the most urgent and invisible threats to health: loneliness.
Former Surgeon General Vivek Murthy recently delivered a stark reminder: Chronic loneliness carries the same mortality risk as smoking 15 cigarettes a day. His warning hits especially hard in healthcare, where digital relationships are on
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Guardrails for AI in Medicare Risk Adjustment: Navigating Innovation Without Losing Control
Implementing AI in Risk Adjustment for Managed Care is like adding rocket fuel to your engine—from accelerating chart reviews to identifying coding opportunities in near real-time, AI can dramatically improve efficiency, accuracy, and compliance. But without the right safeguards, the same tools can just as easily magnify errors, introduce bias, and create costly regulatory exposure.
As Managed Care organizations navigate this rapidly evolving landscape, a key question looms: How
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Pear Suite Secures $7.6M to Scale AI-Powered Community Health Worker Network
What You Should Know:
- Pear Suite, a digital health company dedicated to empowering community health workers (CHWs), today announced it has closed a $7.6 million Series A funding round co-led by Rock Health Capital and Nexxus Holdings.
- The investment will accelerate the development of its AI-powered platform, fuel provider network growth, and expand its impact through new Medicaid and Medicare health plan contracts.
Building Sustainable Infrastructure for Community-Based
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3 Non-Negotiable Practices for Emotional Recovery in Cancer Care
Clinicians rightly celebrate when treatment ends. Yet many patients leave our clinics still carrying the invisible weight of illness—anxiety, low mood, pain, and a fragile sense of self. The evidence says this is not rare, and it is not trivial. A 2025 umbrella review of cancer survivorship found pooled prevalence rates of 33% for depression and 31% for anxiety, with higher figures during periods of wider societal stress. These symptoms shape adherence, function, and quality of life, long after
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Rewriting the Health Economy: 6 Trends Shaping the Future of US Healthcare
What You Should Know:
- The U.S. health economy is at a critical juncture, defined by unchecked prices, inefficiency, and mounting political pressure for reform, according to Trilliant Health’s latest report.
- The report, 2025 Trends Shaping the Health Economy Report, reveals that the fundamental driver of high costs is price, not utilization, necessitating a radical shift in how healthcare value is purchased and delivered.
U.S. Healthcare At A Crossroads
The U.S. spends
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Beyond Bias: 5 Strategies for Clinicians to Deliver Equitable Mental Health
Two 20-year-old males were evaluated at an urban emergency department (based on composite cases). They both experienced hallucinations related to substance use. Both demonstrated depressive symptoms. However, one was diagnosed with schizophrenia, incarcerated for possession of controlled substances, and when released back into the community, received infrequent follow-up care. The other was diagnosed with major depressive disorder, received treatment for both his substance use and mood disorders
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Workforce Insurance: Why Injury Prevention is the Next Frontier of Performance
Prevention Isn’t a Perk — It’s a Competitive Advantage
Every year, U.S. companies lose billions to workplace injuries that could have been prevented — not because they don’t care about safety, but because they’re solving the wrong problem. Most organizations still treat workforce health as a compliance obligation or a claims cost. But the real opportunity lies in building physical resilience directly into operations.
And one thing is clear: prevention isn’t a perk. It’s the next
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ACA Spillovers: A Warning for Employers as Insurers Seek Up to 43% Premium Hikes
What You Should Know:
- The U.S. healthcare market is showing a stark divergence in cost trends between public and private sectors. While Affordable Care Act (ACA) premiums are spiking well above the industry's decade-long trend of sub-10% increases, real-world claims data from self-funded employers show costs holding steady at under 5%, according to new data from Nomi Health.
ACA Rate Hikes Driven by Utilization and Risk
ACA insurers across the country are filing for some
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