Few phrases raise blood pressure among doctors and patients like “prior authorization.” Ask any clinician and you’ll hear the same story: delayed treatments, endless back-and-forth, and vulnerable individuals left waiting while paperwork wins the day.
For providers, prior authorizations are a constant drain of time and energy. For patients, they can mean worsening conditions, missed windows for effective treatment, or even care that never arrives at all. And for payers, prior
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Why Delaying the Hepatitis B Birth Dose to One Month Is a Dangerous Mistake
On Friday, September 19th, the Advisory Committee on Immunization Practices (ACIP) postponed its vote on the hepatitis B birth dose. Since 1992, American newborns have received this shot automatically at birth. ACIP has signaled that it plans to delay hepatitis B vaccination until at least one month of age.
Change is overdue, but this proposed change would represent the worst of both worlds. Giving the birth dose to all kids is problematic, but it means the few who actually need it are
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How Female Bodies Became Political Weapons
Hormones are having their 120th birthday this year—in 1905, British scientist Ernest Starling first coined the term “hormone.” And while so much has developed scientifically since then, so much has stayed the same.
Women and their reproductive systems governed by sex hormones have been pathologized as having “hysteria” for centuries (really–the ancient Greek term for uterus came from the word hysteron). Almost immediately after hormones were discovered, estrogen was named in 1906, after
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Why Healthy Aging Will Not De Delivered By Innovation Alone
We are entering an era where aging is no longer seen as a passive decline, but as a dynamic, measurable, and critically modifiable process. Across biotech, diagnostics, and AI-driven research, the question is no longer can we detect disease, but how early, how precisely, and how personally?
But as our capabilities grow, so too does the infrastructure gap. We now have the tools to map the biological signatures of aging across entire populations through genomics, transcriptomics, epigenetics,
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Pharma × AI: The End of Pilots and the Rise of Captive AI Boutiques
What if the future of drug discovery no longer rests on bold experiments, but on disciplined partnerships where artificial intelligence becomes as indispensable to pharma as the laboratory bench? The answer is arriving faster than many realize.
For years, the relationship between artificial intelligence (AI) startups and big pharma followed a familiar script: a splashy press release, a limited pilot, and then silence after millions were spent in R&D. AI companies gained validation; pharma
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Why Retrospective Audits Are No Longer Sustainable Against Rising Payer Scrutiny
In late 2023, a multi-hospital health system in the Southeast saw a sudden spike in payer requests for documentation. The compliance team had been running routine retrospective audits, but the pace of incoming denials and takebacks began to outstrip their ability to respond. Within six months, the organization reported more than $11 million in at-risk revenue and a doubling of external audit activity.
Despite their best efforts, the system was playing defense.
This story
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Why Ambient AI is Now a Deciding Factor in Clinician Recruitment
Health systems nationwide are grappling with a critical and intensifying challenge: how to attract and retain the next generation of clinical talent.
With the physician shortage not showing signs of slowing down, organizations are in dire need of new strategies to retain the talent they’ve cultivated, while also appealing to younger clinicians who will be essential to meeting the rising demand for care.
Unlike many of their more seasoned counterparts who may be comfortable with
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From Chatbots to Agents: How GPT-5 is Reshaping Healthcare and Pharma
Pharma is embracing GPT-5, shifting AI from chatbot to enterprise agent as it accelerates productivity amid regulatory challenges.
Large pharmaceutical and biotech companies have spent the last couple of years running specific pilots involving artificial intelligence (AI). Learnings from these forays have formed a basis for AI readiness and a guide for industry to weave generative AI into enterprise strategies. Even regulators have been experimenting with AI to offset staff shortages and
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Why AI in Healthcare ERP is the Biggest Opportunity for Cost Reduction
When most healthcare executives hear about artificial intelligence, they think of drug discovery or clinical trials, but the bigger opportunity is happening behind the scenes. Enterprise resource planning (ERP) systems are the backbone of finance, supply chain and compliance, and they’re beginning to leverage AI to transform how healthcare companies understand and act on their data.
By 2025, most major ERP platforms will ship with built-in AI features, but the question is how advanced and
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ACOs Must Lead on Specialty Care to Control Costs
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central goal has shifted to cost control, ACOs will need to broaden scope to optimize specialty care. TEAM (Transforming Episode
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