Current Posts

Highlighting another Host to Host episode on Voices of Self Funding. Host Ramesh Kumar invites Adam V. Russo, host of Health Cent$ to discuss the secrets of saving and delivering a good healthcare experience on a self-funded plan. Take a listen.

Health IT business news from Luma Health, PointClickCare, ABILITY Neurotech, IKS Health, Penguin Ai, HHAeXchange, Aiva Health, Murj, ImpediMed, Motive Medical Intelligence, WellSky, Impact Advisors, AArete, 1upHealth, First Databank, Impact Advisors, Komodo Health, and more.

By Sandra Johnson – There is a better way, one that allows systems to obtain new EHRs with more transparent financial impact. The System as a Service (SYaaS) solution offers a more predictable and manageable approach that delivers all the benefits of a modern EHR but without the enormous upfront costs and additional expenses that can add millions to the investment.

By Natosha McNeal – Agentic orchestration is what makes scale achievable. It sets the boundaries an agent operates within and records every step it takes, with a clinician or compliance check built in wherever the stakes call for it. This allows AI to take on real work while the people accountable for it remain in control.

Reported payers and health insurance industry news from EHVA.ai, UnitedHealthcare, Independence Blue Cross, Anthem Blue Cross and Blue Shield, CVS Health, CareFirst BlueCross BlueShield, Humana, UnitedHealth Group, Cigna Healthcare, AHIP, and more.

By Nargiza Noimann Zander – Digital mental health programs should be judged by whether they expand access and contribute to appropriate care. Engagement is part of that assessment, but it should never be asked to carry the full weight of clinical success.

CMS has released important Quality Payment Program updates. Key updates include the MIPS Value Pathways (MVP) Adoption Survey is now open, 2025 MIPS Final Scores and Targeted Review timeline, & reminder to submit comments on the CY 2027 PFS Proposed Rule Policy Changes for Quality Payment Program by 9/14/2026.

Starting October 11, in Salt Lake City, the Thru-Put Healthcare Operations Summit will dive into evidence-based operations and leadership best-practices, giving you practical strategies you can use with your teams. Check out the Workforce, Culture & Staffing Track.

By Christy Winter – For decades, paper-based authorizations have stalled the healthcare industry, creating administrative backlogs for care teams and critical treatment delays for patients. On average, practices spend 13 hours each week completing 40 prior authorizations per clinician, a massive administrative burden that diverts nearly 700 hours from patient care annually.

Starts October 13th in Redwood City CA – They are taking this year’s event to the West Coast and bringing members, partners, and prospective participants together in Redwood Shores, just outside San Francisco, for two days of conversation, collaboration, and strategy around the future of interoperability.

The Centers for Medicare & Medicaid Services, through the Center for Clinical Standards and Quality, is launching QualTech, an industry event initiative designed to identify innovative technology solutions aligned to key quality-related priorities and advance better health outcomes for all Americans.

By Angel Mena MD – The health systems that reinforce their operational foundation with consolidated tools, shared data, and regularly examined workflows will be better positioned to deploy AI, maximize its potential, and be more resilient for the industry regulations and financial pressures ahead.

Newly released episode of AI Amplified. Host Dr. Heather Bassett talks to Rom Eizenberg, Chief Revenue Officer and Head of Product Innovation at Kontakt.io, to explore a blind spot in healthcare AI investment: while clinical technologies have attracted enormous attention and funding, the operational infrastructure supporting care delivery has been largely overlooked.

We have rounded up some reports and surveys from around the industry that we thought were of interest from Cognizant, CHG Healthcare, HHAeXchange, CHIME, Peterson Health Technology Institute, and more.

In this monthly report you will find news and highlights in the Applied Life Sciences from OSR Health, Clearmind Medicine, Kupando, Touchlight, ProBioGen, Celonic AG, Thrombolytic Science, Devonian Health Group, SpotitEarly, Neurizon® Therapeutics Limited, AlphaRose Therapeutics and more.

By Lionel Litty – The incidents that slip past an organization’s defenses show up as a routine email, an ordinary link, or a file that looks exactly like the hundreds of legitimate ones an employee opens every week. Across healthcare organizations, security teams are discovering that attacks bypassing every layer of their stack trace back to the same entry point: the browser session.

Find a new podcast or catch up on some of your favorites, here are all the newest episodes released this week on Healthcare NOW Radio. Have a great weekend!

We have rounded up some virtual events around our industry. They are all free to attended so register today. And check back each week for new events. Have an event we can include? Contact us.

By Jim Kirk – Healthcare organizations are gaining more visibility into their cybersecurity risks, but identifying vulnerabilities is only the first step. Fortified Health Security’s 2026 Mid-Year Horizon Report examines the growing gap between risk detection and remediation, and the foundational areas healthcare leaders must prioritize to strengthen cyber resilience.

Business and financial news from Hinge Health, Amae Health, OpenEvidence, PwC, Zyter, Medbridge, Ascend Learning, OSF HealthCare, Curative Health Insurance, Included Health, WellSky, CHG Healthcare, Novo Nordisk, Amazon Web Services, HealthSnap, iRhythm Holdings, EnableComp, Intermountain Health, BioCare, CheckedUp, and more.

By Brian Robertson -To improve revenue cycle management (RCM) through AI, organizations first have to change how they see the revenue cycle itself. RCM is no longer operational support. It is a core driver of enterprise strategy, corner office and all.

By Melissa Kotrys – Healthcare interoperability has made meaningful progress, but gaps remain between the national vision and the realities of local health information exchange. Achieving truly seamless, accessible data sharing requires national and local initiatives to work together, ensuring progress translates into meaningful impact for the communities and organizations that rely on it.

This month’s AI report includes news and updates from Apella, Causaly, Definitive Healthcare, Luma Health, MDaudit, ModMed, MUSC Health, Nabla, PerfectServe, Relatient, Sage, Sheba Medical Center, and ThinkSono.

By April Miller – Managing medical facilities requires coordinating finance, procurement and patient-facing operations across complex systems. Enterprise resource planning (ERP) platforms can centralize these functions and provide healthcare leaders with stronger operational visibility to control costs and allocate resources effectively.

The Sequoia Project, the leading non-profit focused on advancing healthcare interoperability, announced it will continue its role as the Recognized Coordinating Entity® (RCE®) to support the implementation of the Trusted Exchange Framework and Common Agreement™ (TEFCA®).

Latest announcements made from companies and organizations on hiring include Health Gorilla, AArete, Vida Health, Iterative Health, NYU Langone Health, NAHQ, Healthcare Management Administrators, Blue Shield of California, Royal Health, HCAA, Corundum Corp., Eagle Telemedicine, eHealth Exchange, The Sequoia Project, Reach for Resources, St. Joseph’s Health, Healthworks, & AmeriHealth Caritas.

By David Harvey – Managing chronic diseases remains a significant challenge in U.S. healthcare, both in terms of the total cost of care and poor patient outcomes. The CDC estimates that 90% of the nation’s $5.3 trillion annual healthcare expenditures go toward preventing, treating, and managing chronic disease (including both physical and mental health chronic conditions).

Starts October 6th in New York City – This year, they are addressing the urgent issue of care moving outside hospital walls faster than the workforce can adapt. With nursing shortages, primary care deserts, and an aging population outpacing available clinicians, hiring alone will not solve these challenges.

Can the RHT initiative turn the deepening decline of rural healthcare around? Who will take on the challenges to not just spend the $50B but change the rural healthcare landscape? Here is what’s in the news this month.

By Fawad Aslam – A patient who cannot explain her symptoms is a patient at risk. A discharge plan that is not understood is a readmission waiting to happen. Communication failures driven by language barriers affect diagnosis, treatment adherence, informed consent, and patient safety, and for more than 26 million Americans with limited English proficiency, they are a routine feature of seeking care.

NOW on-demand, Value-Based Care Insights host Daniel J. Marino speaks with Katie Gilfillan, Director of Healthcare Finance Policy at HFMA. They discuss how the conversations at this year’s HFMA Annual Conference made one thing clear: value-based care is no longer just about reimbursement; it’s becoming the foundation for how healthcare organizations operate.

By Gerardo Herrero – Interoperability conversations in the United States tend to assume a shared floor: one national framework, one certification program, one set of standards everyone is nominally moving toward. Latin America offers a useful counterfactual.

The thought leaders in our community are good about sharing their thoughts on the issues of today. Here are the top read and shared guest posts of July that we think deserve sharing again.

By Anne Neal – For years, the industry has measured payment integrity success largely through recoveries, savings, and avoided overpayments. However, achieving those metrics often comes at the cost of significant abrasion that manifests as claims rework, provider tension, cash flow unpredictability, and poor member experience.

By Matt Fisher – The Centers for Medicare and Medicaid Services released its proposed 2027 Physician Fee Schedule for Medicare (the 27 PFS) on July 14, 2026. The 27 PFS contained a pretty big surprise: a complete shift in approach to the two primary modes of remote monitoring: remote physiologic monitoring and remote therapeutic monitoring.

Health IT business news from CereCore, Solventum, ModMed, Nabla, Wolters Kluwer Health, ModMed, DSS, AGS Health, Definitive Healthcare, Collette Health, OMNY Health, Inovalon, PerfectServe, WellSky, ThinkSono, SafeRide Health, VirtuAlly, Impact Advisors, and more.

By Khalid Sattar – Healthcare has spent decades optimizing care delivery. It has invested billions in clinical excellence, advanced diagnostics, modern facilities, digital records, and operational efficiency. Yet one of healthcare’s greatest challenges still occurs before care even begins. Patients struggle to access the system.

By Syed Sibt-e-Hassan – Most practices judge a good month by the balance in the bank. It is the slowest and least useful way to understand revenue. By the time a shortfall shows up in the account, its causes are weeks old and often past the point of recovery.

Moving our healthcare system into the digital age, better outcomes, controlling and reducing costs, and patient access to their health data. Our monthly HIE rundown includes updates on industry interoperability news, TEFCA, HIE networks, job openings and vendor contracts.

By Theo Sakalidis – When I worked on the buy side of healthcare private equity, we underwrote a lot of physician practices. And I can tell you that the clinical work, the thing the doctors trained a decade to do, was almost never the thesis. The thesis was the back office.

The math was simple and unforgiving: the company couldn’t scale to serve new clients without physically scaling its call center, and physically scaling a call center is slow, expensive, and hard to reverse. The question isn’t whether AI can handle provider calls, it’s how much capacity is sitting on the table until it does.

Advanced practice providers (APPs) have moved from a reactive staffing solution to a foundational pillar of U.S. healthcare workforce strategy, according to a new survey of 327 healthcare facility leaders from CHG Healthcare, the nation’s leading physician and advanced practice workforce company.

By Pat Williams – When healthcare leaders talk about ambient AI scribing, they almost always picture the same setting: a primary care physician, managing a panel of 15 to 20 patients, dictating notes between appointments. That’s the benchmark the industry has built its expectations around.

Starts October 26th in San Diego – We’re in an era of rapid transformation across managed care pharmacy. Artificial intelligence, political volatility, and scientific breakthroughs have all made their mark on managed care, and AMCP Nexus 2026 is where leaders come together to make sense of what’s changing and shape what comes next.

CMS issued multiple Fiscal Year (FY) 2027 final payment rules in late July 2026. These rules update payment rates, quality programs, and reporting timelines across acute care, long-term care, inpatient rehabilitation, skilled nursing, and hospice settings, generally taking effect on October 1, 2026.

By Sanjay Subramanian – Some of the most expensive work in healthcare is the work no one counts as care. Physicians and their teams chase authorization status, resubmit records, clarify denial reasons, and explain coverage confusion to patients.

The CereCore Podcast release: On this episode of The CereCore Podcast, they welcome back Lynn Falcone, CEO of Cuero Regional Hospital, and Ismelda Garza, CIO of Cuero Regional Hospital and CereCore manager, for a candid conversation about their multi-year effort to implement MEDITECH Expanse and evolve into a high reliability organization (HRO).

By Amy Oliver – I have always cared about healthcare access and equity. But recently it stopped being just a professional conviction and became something messier and more specific, the kind of care that comes from watching the system fail someone you love and not being able to do anything about the system, only about showing up.

Health IT product news from 1upHealth, Cantata Health, CareHive Health, Caris Life Sciences, Carta Healthcare, MedeAnalytics, Trice Workspace, Teladoc Health, AGS Health, HOPPR, Luma Health, MDaudit, Pacific AI, Relatient, Revecore, SimplePractice, & Talkdesk.

By Kamya Elawadhi – When did “we believe we reached physicians” become an acceptable standard for a billion-dollar industry? Somewhere along the way, pharma marketing made peace with probabilistic targeting, inferred identities, and impression counts that looked impressive but proved little.

NOW on Demand Tell Me Where IT Hurts episode with host Dr. Jay Anders and his guest Anna Dover, PharmD, Senior Director of Editorial Content at First Databank (FDB). Together they unpack pharmacogenomics, using a patient’s genetic profile to predict which drugs will work and which will cause harm, and why it’s one of the most exciting frontiers in personalized medicine.

Business and financial news from SpinSci, CliniComp, Gr4vy, Wizlo, CharmHealth, Telemynd, RevealDx, Buzz Health, Wolters Kluwer Health, Wildflower Health, Cardinal Health, H1, Novo Nordisk, WHOOP and more.

By Dr. Patricia Hayes – We spend more on children after they’re sick, in admissions and emergency visits, and far less on the proactive care that keeps them safe at home. We pay for the crisis and underfund the work that would have prevented it. That’s why adding clinicians or expanding telehealth only goes so far.

By Matt Fisher – The biggest recent news for HIPAA is the quiet reveal that updates to the Security Rule are now delayed until sometime in the middle of 2027. The update was made on an Office of Management and Budget webpage, which now shows expected final action as an undefined date in July 2027.

We are seeking out the latest developments around virtual healthcare. News from Teladoc Health, Implicity, Wizlo, Gr4vy, Telemynd, TytoCare, and more.

By Abhishek Gupta – Despite the strong investments in data and analytics, VBC’s promise remains largely unfulfilled. Most organizations have invested in analytics dashboards that surface insights but don’t drive action. A closer look reveals why.

In this week’s special edition of “News You Can Use” on Healthcare NOW Radio Dr. Nick sits down with Adam Russo, CEO and Founder of The Phia Group, to explore Fiduciary liability and what employers and brokers need to know about health plan oversight.

Latest announcements made from companies and organizations on hiring include Ellipsis Health, AllyGPO, Trialbee, OptimizeRx, AGS Health, NASCO, Carenet Health, Ebix, Nabla, Availity, AArete, Bridge Oncology, DirectTrust, Point-of-Care Partners, Pivot Point Consulting, & FINN Partners.

By George Bosnjak – As someone currently building my fourth healthcare technology company, I’ve learned to value practical, hard-working solutions over the flashy hype touted by Silicon Valley. So, when Pope Leo XIV released his encyclical Magnifica Humanitas addressing the rapid rise of artificial intelligence and its potential consequences, I paid attention.

Starts November 11th in Denver – This fall, healthcare leadership rises higher. The CHIME26 Fall Forum is a gathering at altitude, bringing together digital health’s most influential leaders in Denver, Colorado, where perspective sharpens, challenges are met head-on, and the path forward comes into focus.

ATA Action sounds alarm as CMS’ PFS Proposed Rule threatens to reverse bipartisan congressional gains on remote patient monitoring.

By Jay Anders MD – Behind the polished demos and bold promises, a large language model remains a fast, powerful next-word predictor. It reviews an enormous matrix of possibilities and generates the word it calculates should come next. It does this so well that it can appear to reason. But it does not reason as clinicians do. It predicts.

NOW on-demand, Value-Based Care Insights host Daniel J. Marino speaks with Ivan Mitchell, CEO of Great Plains Health, to discuss why his organization made the difficult decision to terminate its Medicare Advantage contracts.

Our monthly round up of nurses news, from the associations, providers, hospital systems, and nurses themselves.

What makes marketing in the health IT space unique? Who are the movers and shakers? What’s working, what’s trending? Where can you learn more? News from Swaay.Health, anthonyBarnum, Brafton, Sōvyn, Unlock Health, Innsena, Klick Health, O’Dwyers, Privia Health, & more.

By Lauren Barca MHA RN BSN – Health plans are reaching more members than ever before, but that has not necessarily translated into better engagement or better outcomes because most of that effort stops after the first interaction.

Marking the one-year anniversary of the Health Tech Ecosystem Initiative when the private‑sector health‑tech companies pledged to help CMS modernize data exchange. So what is the progress? There has been some meaningful progress, some lagging areas, and need for continue multi-stakeholder coordination.

Health IT business news from Heidi, Nexus, Arcadia, Commure, MedScout, The BRAIN Foundation, ShelterZoom, WellSky, Inovalon Inc., Ardent Health, Arbital Health, deliverz.ai, Relatient, Veritas Association Management, Net Health, Imagine Pediatrics, Implicity, Carta Healthcare, Ebix, and more.

By Gurkan Camok MSc – Healthcare AI is often introduced through a performance metric: accuracy, sensitivity, specificity, or speed. Those measures matter, but hospital adoption is determined by a different question. Can the system deliver useful, understandable guidance inside a real clinical workflow without creating new delay, confusion, or risk?

By Rafiq Ahmed – For decades, one of the most consequential numbers in healthcare was effectively invisible to the providers delivering care: what a payer actually reimburses a hospital for a given service. Health systems negotiated contracts based on internal assumptions, historical precedent, and incomplete intelligence about what the market was actually paying.

Looking for a conference to attend this Fall? Check out these five events to consider: Civitas Annual Conference, 2026 Health Policy Conference, AMCP Nexus, CHIME26 Fall Forum, and HLTH 2026.

By Tyler Cobb – A certificate of insurance is a one-page summary issued as a convenience. It is not a policy, it confers no rights, and it says almost nothing about whether the endorsements behind it actually match what the contract requires. Third-party risk has become a primary exposure pathway for provider organizations.

By Jazmin Orozco Rodriguez – As the Trump administration’s January deadline looms for states to enforce new Medicaid work requirements, some state lawmakers are turning the tables by pushing to publicly name the largest companies that have employees enrolled in the government program covering low-income and disabled people.

By Felicia Sadler MJ BSN RN CPHQ LSSBB – According to a 2026 Nursing Outlook study, the societal cost of losing a Minnesota specialty nurse reached nearly $3.7 million, highlighting why workforce retention should be viewed as an infrastructure investment rather than simply a staffing concern.

By Jerry Smith – Drug affordability conversations often center on manufacturers and their high list prices. This focus overlooks the real cost driver: the complex pharmaceutical ecosystem.

Starts September 28th in Atlanta GA – The 2026 AvaSure Symposium brings together nurse leaders, IT innovators and operational executives who are actively modernizing care delivery. This is where strategy meets implementation. Where outcomes matter. And where leaders share what’s working and what’s next.

By Adam Wong – What started as a challenge to tame unwieldy single patient electronic health information (EHI) exports, often hundreds of pages long and hard to use, quickly became a nationwide surge of ingenuity, with nearly one hundred proposals pouring into the ONC EHIgnite Challenge.

By Anita Nayak – Across hospitals, health systems, and provider organizations, leaders are exploring how AI can support documentation, predictive analytics, patient engagement, revenue cycle management, administrative workflows, and clinical decision making.

NOW on-demand, Value-Based Care Insights host Daniel J. Marino speaks with Dr. Angel Martino-Horrall, anesthesiologist, consultant, and perioperative operations expert, to discuss the evolving role of anesthesia leadership in surgical services governance.

By Megan Schmidt – Healthcare is spending billions to modernize the future while ignoring one of its most expensive operational failures. Provider data, the foundational information that determines who gets paid, where patients receive care, and how networks function, remains inaccurate across much of the industry.