A new peer-reviewed study analyzed real-world data from patients of a large, risk-bearing provider, who were also covered by one of New Jersey’s largest health plans. It found that a non-invasive, home-based treatment for knee and back pain reduced musculoskeletal…
Author: Vedant Bhosale
Effective data interoperability in healthcare is no longer an optional enhancement; it’s an essential function for modern medical systems. With its potential to significantly improve operational efficiency and patient outcomes, interoperability ensures seamless communication between diverse healthcare systems. Federal mandates…
Health plan executives and marketing leaders are facing intensifying pressure to grow member volumes, improve outreach and engage consumers digitally — all while navigating an evolving legal minefield of data privacy risks. At the heart of the challenge lies the…
At Becker’s 15th Annual Meeting, leaders from Microsoft and Blue Shield of California shared how AI is one tool to help transform payer operations — not by replacing humans, but by personalizing care, cutting friction and restoring trust. Christine McKinney,…
How to Build a Technology-First Strategy for UM Effective utilization management (UM) begins with a strategic approach grounded in technology, data, and continuous improvement. As AI adoption accelerates, payers must align their UM strategies with both regulatory demands and operational…
Health system executives are under growing pressure to manage tighter margins, navigate shifting reimbursement models and cultivate strong payer relationships. At the same time, unprecedented volumes of pricing data are becoming available, offering health systems a new source of insight…
Generative AI Pioneering the Future of Utilization Management The healthcare industry is rapidly positioning Generative AI (GenAI) at the forefront of Utilization Management (UM) reform. Far from being a speculative technology of the future, GenAI is here to transform stagnant…
Digital tools with a human touch — 4 takeaways on Magellan Health’s partnership with Calm Health
During a featured session at Becker’s Spring Payer Issues Roundtable in April, leaders from Calm Health and behavioral health provider Magellan Health shared a blueprint for marrying clinical rigor with digital engagement to expand access to behavioral healthcare. Chris Mosunic,…
When medically complex patients require hospital care, they tend to experience longer recovery times than other patients do and are more likely to readmit to the ICU.1,2 Kindred Hospitals, a network of long-term acute care hospitals (LTACHs), is focused on…
From friction to function: 4 takeaways on fixing provider data to improve member access and trust
During a featured panel discussion hosted by Kyruus Health at Becker’s Spring Payer Issues Roundtable, leaders from Highmark Health, Allegheny Health Network, Corewell Health and UCare came together to dissect one of healthcare’s quietest crises: provider data inaccuracy. The panel…
