Health insurers and health care provider organizations are increasingly using artificial intelligence (AI) tools in prior authorization and claims processes. AI offers many potential benefits, but its ...

There is a growing urgency to mitigate rising atmospheric carbon dioxide levels. In recognition of the dynamic, multifaceted, and sometimes heavily debated nature of processes for carbon capture, ...

Add Yahoo as a preferred source to see more of our stories on Google. Community Health Systems sued MultiPlan on May 8, 2024, alleging the cost management firm is colluding with health insurers to ...

Imagine a restaurant open 24 hours a day, 7 days a week that always maintains a full staff. With the exception of weekend nights and the lunch rush, the restaurant will be empty a lot of the time. But ...

For years, utilization management (UM) was quietly delegated away for scale, speed, and supposed efficiency. But today, health plans are hitting the breaking point. Prior authorizations, a core ...

A monthly overview of things you need to know as an architect or aspiring architect. Unlock the full InfoQ experience by logging in! Stay updated with your favorite authors and topics, engage with ...

Objective Performance Status: Enhancing Cancer Patient Fitness Assessment With Wearable Technology Identification of patients at risk and providing supportive interventions with the goal of reducing ...

As the major insurers reported their second-quarter financial results at the end of last month, a theme emerged: higher-than-expected costs driven in part by higher-than-expected utilization. But Hal ...

Q: Do you have any suggestions on how to make the Utilization Review and Triple Check processes more efficient? A: Implementing a robust Utilization Review and Triple Check process serves several ...

BEIJING, Aug 5 (Reuters) - China's renewable power potential in far-flung provinces is increasingly going unused, official statistics showed on Monday, as the country rushes to build more ...

Two topics dominate almost every conversation about value-based care (VBC): risk adjustment and quality. They are, without question, foundational. Risk adjustment sets the financial baseline for each ...