Why Quality Shareback Is the Missing Fuel for the Healthcare Interoperability Engine
Healthcare interoperability has largely solved data access, but the missing piece is high‑quality shareback—returning clinically relevant information after use. Patrick Lane argues that without structured, provenance‑rich, machine‑readable feedback, exchanges remain one‑way and fail to demonstrate outcome improvements. He outlines five traits of effective shareback and highlights the ambiguous role of intermediaries such as QHINs. The article calls for policy and governance reforms that make shareback a measurable metric, turning interoperability into a true Learning Health System.
The Healthcare Industry Has a Last Mile Problem — It Hasn’t Realized It Yet
The article highlights a “last‑mile” gap in U.S. healthcare, where post‑appointment coordination for seniors often collapses. Discharges, medication adherence, and social‑determinant support lack dedicated resources, leading to readmissions and wasted care. Misaligned fee‑for‑service incentives and unclear accountability keep the problem...
How the DOJ Is Tackling Fraud in the ACA Marketplace
At a Las Vegas conference, the DOJ highlighted a growing fraud scheme in the ACA Marketplace that preys on homeless, unemployed and mentally‑ill Medicaid recipients. Street marketers falsify denials, open special enrollment periods, and become agents of record, repeatedly switching...
Wearable Noise Is Exploding — Trust Is the Filter
Consumer wearables have evolved from simple fitness accessories into continuous health monitors, flooding the system with unprecedented physiological data. Clinicians, however, are hesitant to rely on these streams because provenance, validation, and accountability remain unclear. Without clinical‑grade validation, wearables stay...
Trust, Technology and the Future of Interoperability: Solving Problems That Impact Real Lives
Healthcare interoperability remains a critical bottleneck, with missing data causing delays, medication errors, and higher readmission rates. Research shows a 79% jump in 7‑day readmissions when discharge summaries aren’t shared promptly. The 2025 CMS Interoperability Pledge, built on TEFCA and...
Alignment Health Plan CEO: Sometimes When MA Plan Is Pulling Out, the Provider Is to Blame
Medicare Advantage (MA) plans are retreating from markets as hospitals demand excessive reimbursement, prompting a "fundamental reset" in the sector. Alignment Health Plan CEO Dawn Maroney argued that hospital systems, not insurers, are the primary cause of plan pull‑outs, citing...
The Next Era of Payment Integrity: Earlier Clinical Validation, True Transparency
Health plans are moving payment integrity left by applying clinical and coding validation before claims are paid. The industry faces over $200 billion in annual waste and abuse, and legacy post‑pay processes consume a third of integrity resources. Leveraging domain‑specific AI...
Revenue Isn’t the Signal: What Early-Stage Health Tech Investors Should Be Watching Instead
Claire Smith of SpringTide Ventures argues that early‑stage health‑tech investors should look beyond headline revenue. She emphasizes customer adoption, sales motion, and scalability within regulated systems as stronger predictors of success. Early contracts may be modest but valuable if they...
Policy Expert Believes CMS Is Taking “Adversial Posture” To Medicare Advantage
At the Medicarians conference, policy analyst Tom Kornfield warned that CMS is taking an increasingly adversarial stance toward Medicare Advantage (MA) amid concerns about overpayments, fraud and political scrutiny. The agency cites $76 billion in excess payments and recent data‑validation audits,...
OSHA’s Evolving Approach to Workplace Violence Prevention in Healthcare
OSHA is conducting its first workplace‑violence audit in 25 years, highlighting growing scrutiny of safety in health‑care settings. While a federal standard on health‑care violence has been shifted to Long‑Term Action status, delaying any rule for at least a year,...
Stopping Patient Attrition Before It Starts: A Proactive Approach to Healthcare Marketing
Healthcare leaders are shifting focus from pure patient acquisition to proactive retention, recognizing that capacity limits and rising marketing costs make keeping existing patients essential for revenue stability. Retention safeguards the trust investment made during onboarding and reduces churn that...
Is Shah Capital’s Criticism of Novavax Fair? A Wall Street Analyst Weighs In
Novavax faces renewed activist pressure as Shah Capital, a 9% shareholder, announced it will vote against the company’s board and executive compensation at the 2026 annual meeting. The hedge fund criticizes the under‑performing $22 million sales from the 2024 Sanofi partnership...
Expanding the CJR Model Is a Logical Step in VBC, but Implementation Challenges Remain
The Centers for Medicare & Medicaid Services (CMS) has proposed expanding its Comprehensive Care for Joint Replacement (CJR) Model into a mandatory, nationwide program called CJR‑X, slated to start on October 1, 2027. The model will hold hospitals accountable for total Medicare...
How Team-Based and Virtual Nursing Models Are Redefining Care Delivery
Nurse leaders are shifting from traditional, siloed staffing to team‑based and virtual nursing models to combat rising patient acuity, chronic workforce shortages, and burnout. By integrating licensed practical nurses, nursing assistants, and remote clinicians, hospitals free bedside RNs to focus...
Trust and AI Adoption in Medicine
Artificial intelligence has moved from administrative shortcuts to core clinical workflows, making healthcare one of the fastest‑growing AI sectors. Clinicians are eager to use AI for faster charting, yet many adopt tools without fully grasping data handling or model limitations....
Behavioral Health Demand Has Increased by 62% Since 2018. What the Industry Needs to Know
The 2026 Trilliant Health Behavioral Health Report shows a 62.6% jump in utilization since 2018, with visits reaching 1,346 per 1,000 people by 2024. Anxiety‑related visits surged 89.3%, especially among women aged 18‑44, while telehealth now accounts for roughly two‑thirds...
Your Doctors and Nurses Are Burned Out. Here’s What They Need
Clinician burnout is accelerating as doctors and nurses grapple with intensified patient acuity, erratic scheduling, fragmented communication, and excessive administrative tasks. Front‑line staff repeatedly cite three non‑salary levers—predictable, equitable schedules; clear, unified communication; and reduced non‑clinical workload—as essential to staying...
Wisp, Visby Partner to Expand Access to At-Home STI Test
Wisp has partnered with Visby Medical to offer Visby’s at‑home PCR test for chlamydia, gonorrhea and trichomoniasis. The palm‑sized test costs $149.99, delivers results in 30 minutes via a mobile app, and is FDA‑authorized. Positive results trigger free virtual follow‑up...
Startup Nula Emerges to Advance a New Class of Medicines for Metabolic Disease
Nula Therapeutics, a New York‑based biotech, has emerged from stealth to develop a new class of medicines that restore nuclear‑envelope function, a target linked to metabolic stress and aging. Its lead small‑molecule candidate, NLT‑101, is slated for a Phase 1 trial...
The Key Biomarkers Changing How and When We Diagnose Alzheimer’s Disease
Alzheimer’s disease will affect nearly 14 million Americans by 2060, with annual care costs projected to exceed $384 billion. The FDA has approved disease‑modifying therapies such as lecanemab and donanemab for patients with mild cognitive impairment, creating a demand for earlier, more...
The End of Incrementalism: Why Healthcare Innovation Is Finally Reshaping the Model
Healthcare innovation is shifting from costly, incremental upgrades to AI‑driven models that make the traditional hospital‑centric system economically untenable. Pioneers such as Ro and Transcarent demonstrate that new platforms can lower total care costs rather than merely reallocating expenses. Continuous...
New Bill Seeks to Lower Out-of-Pocket Drug Costs
Rep. Greg Murphy (R‑North Carolina) introduced the Every Dollar Counts Act, requiring that out‑of‑pocket spending on covered prescription drugs count toward patients' deductibles and annual out‑of‑pocket limits regardless of purchase channel. The bill targets the current practice where many health...
Why Innovaccer Is Pouring $250M Into Its Agentic AI Platform
Healthcare AI firm Innovaccer announced a $250 million, three‑year investment to expand its agentic AI platform built on the “Gravity” unified data layer. The platform deploys AI agents across patient access, value‑based care, revenue cycle, risk assessment and utilization management, delivering...
From Insight to Intervention: Why Over-the-Counter Digital Therapeutics (ODTx) Are the Next Step for LLMs and Wearables
Over‑the‑counter digital therapeutics (ODTx) are emerging as a regulated, consumer‑accessible bridge between data‑rich wearables, AI‑driven language models and clinically proven treatment. Unlike wellness apps, ODTx are classified as software‑as‑a‑medical‑device and must secure FDA authorization, allowing them to make evidence‑based therapeutic...
The Last Mile Problem in AI Radiology: Detection Improves, Follow-Through Breaks
AI tools are dramatically improving the detection of pulmonary nodules and other incidental findings in radiology, but hospitals struggle to translate those alerts into completed follow‑up exams. The handoff chain—from radiology report to electronic health record order, scheduling, and final...
Vida Health Teams Up with ŌURA to Provide More Personalized Metabolic Care
Vida Health, a virtual cardiometabolic care provider, announced a partnership with wearable maker ŌURA to embed biometric data from the Oura Ring into its clinical programs. The integration gives care teams access to continuous sleep, heart‑rate variability and resting heart...
5 of the Top 10 U.S. Health Systems Are Moving to This New Health IT Category. Here’s Why.
Health systems have built fragmented AI "agent" stacks that operate on isolated data slices, leading to mis‑aligned decisions and limited impact. The core issue is a lack of unified context across clinical, financial and operational information. Innovaccer’s Gravity platform introduces...
Why Synthetic Data Is the Antidote to Clinical Trials
Synthetic data, digital twins, and AI are reshaping medical‑device trials by generating virtual patient cohorts that reduce enrollment needs and cut validation costs. The FDA’s in‑silico guidance and EMA’s acceptance of AI tools are paving regulatory pathways for these simulations....
Clinical Supply Chain Hits Its AI Turning Point
AI is reaching a tipping point in the clinical supply chain, with McKinsey forecasting real‑time inventory, predictive replenishment and automated procurement. Agentic AI solutions will shift operations from reactive to predictive, delivering cost‑intelligence, operating‑room optimization, infection‑risk mitigation, robotic‑surgery ROI and...
Hospital Margins Squeeze as Costs Outpace Revenue Growth
Kaufman Hall’s analysis of 1,300 U.S. hospitals shows operating margins at 1.9% in February, up from 1% in January but far below the 3.7% year‑end 2025 level. Revenue grew 5% month‑over‑month, yet expenses rose 5% from January and 6% year‑over‑year,...
Report: Growth in MA Is Associated With Lower Total Medicare Spending
Medicare Advantage enrollment surged from 11 million in 2010 to 32 million in 2024, now covering 54% of beneficiaries. A new Elevance Health study links higher MA penetration to lower total Medicare spending, estimating a 1.5% per‑capita reduction—or $194—without risk‑adjustment, and 1.1%...
The AI Value Gap and Why Validation Is a Practical First Win for Life Sciences
AI adoption in life‑sciences is hampered by a wide value gap, with only about 40% of firms seeing EBIT impact and most gains under 5%. A practical entry point is FDA‑oriented computer system validation (CSV) and computer software assurance, where...
Trust Before Triage: Why I Let the Patient Help Write the Agenda
In safety‑net clinics, clinicians are increasingly pressured by EMR alerts to chase quality metrics before hearing the patient’s story. Samuel Logan, a nurse practitioner, argues that starting with the question “What can I do for you today?” restores trust and...
Two New Takes on Making a Type of Targeted Cancer Therapy Even Better
Two biotech startups announced fresh capital to boost next‑generation antibody‑drug conjugates (ADCs). Sidewinder Therapeutics raised a $137 million Series B, bringing total funding to $162 million, to develop bispecific ADCs that bind a tumor‑driving receptor and an internalizing receptor, aiming for tighter cancer...
Inside The DOJ’s Hospital Contracting Crackdown: What Message Are the Feds Sending?
The Justice Department has filed antitrust lawsuits against OhioHealth and NewYork‑Presbyterian, accusing them of using “all‑or‑nothing” contracts that force payers to accept entire health‑system networks. The complaints argue these tactics suppress competition, keep prices high, and limit patients’ ability to...
What ‘The Pitt’ Gets Right About Emergency Medicine — and What It Reveals About Healthcare IT
The article uses HBO’s *The Pitt* to illustrate how identity‑management friction hampers emergency‑room efficiency. Repeated logins, password resets, and locked workstations add seconds that cascade into longer wait times, clinician burnout, and higher error risk. With CMS and HIPAA tightening...
ACA Stress Test: Four Key Takeaways From This Year’s Open Enrollment
The 2026 ACA open enrollment saw 23 million individuals enroll, a modest decline from 2025 but far from the predicted collapse. Enrollment fell sharply in North Carolina but rose in California, Maryland, Texas, D.C., and New Mexico, which fully offset lost subsidies....
Know Your Patient: How Technology Can Help Health Care Providers Dramatically Improve One Key Aspect of the Patient Experience
The article argues that AI can close the biggest gap in patient experience—feeling understood—by automating note summarization and turning wearable data into actionable insights. It notes that simple digitization of records has not reduced clinician workload, leaving patients frustrated and...
Healthcare’s Most Fixable Cost Problem: Administrative Waste
Healthcare administrative costs are spiraling, with urban hospital admin expenses up more than 90% between 2011 and 2022 while overall hospital services grew 66%. Premiums for employer‑sponsored plans are already 10% higher this year, and the burden on employers is...
Which Health Plans Rank Highest In Digital Experience?
The JD Power U.S. Healthcare Digital Experience study evaluated 7,687 members across the 17 largest Medicare Advantage and 16 largest commercial health plans. Cigna Healthcare topped the commercial segment with a 684‑point score, while UPMC Health Plan led Medicare Advantage...
Gilead and Roche Bet on Protein Degraders for Their Cancer Drug Pipelines
Gilead exercised its option to license Kymera Therapeutics' CDK2 molecular‑glue degrader KT‑200, triggering a $45 million payment and opening a potential $665 million milestone path, with an IND target of 2027. Roche paid $20 million upfront to C4 Therapeutics to co‑develop degrader‑antibody drug...
AI-Driven Precision Care Is the Fix for Our Health System’s Failures
Primary care physicians face chronic time constraints, often resorting to rushed exams and delayed specialist referrals that exacerbate patient outcomes. AI‑driven precision care tools act as intelligent clinical assistants, surfacing relevant chart data, suggesting differential diagnoses, and drafting evidence‑based treatment...
The Quiet Battle for the Front Door of Healthcare
The article argues that control of primary care—the “front door” of the health system—has become a strategic battleground for hospitals, insurers, employers, and emerging platform companies. Hospital systems have been buying primary‑care practices to capture referral revenue, while insurers such...
How to Use Real-World Data to Improve Drug Development, Starting with the Patient Journey
A new eBook from PurpleLab and MedCity News highlights how real‑world data (RWD) can expose hidden gaps in the non‑small cell lung cancer (NSCLC) patient journey, such as missed biomarker testing and transportation barriers. Recent state legislation now requires insurers...
Rural Healthcare Transformation Has to Focus on the Real World, Not Techno-Fantasies
The CMS is rolling out $50 billion in Rural Health Transformation (RHT) grants to help under‑funded clinics streamline operations and improve care. Rural hospitals face chronic staffing shortages, shrinking patient volumes and thin margins, with more than 40% operating at a...
It’s Time to Put Guardrails on GLP-1 Compounding
The article warns that the rapid rise of compounded GLP‑1 drugs—spurred by a shortage of FDA‑approved semaglutide and tirzepatide—has created a largely unregulated market fraught with safety risks. The FDA recorded 1,150 adverse‑event reports, including hospitalizations and deaths, linked to...
The Power Behind Enterprise EHR Software for Large Healthcare Systems
Enterprise electronic health record (EHR) platforms are becoming the operational backbone for large healthcare systems, offering a unified, cloud‑based architecture that supports multiple facilities, specialties, and tax entities. Core capabilities include real‑time data synchronization, API‑first interoperability, built‑in HIPAA and ONC...
Do Healthcare CEOs Agree on Whether VBC and MA Actually Save Money?
Healthcare CEOs debated whether value‑based care (VBC) and Medicare Advantage (MA) actually cut costs. Some executives, like Arcadia’s Michael Meucci and Risant Health’s Jaewon Ryu, see untapped potential in fraud‑reduction and population‑health management, while others, such as Shawn Gremminger, claim...
Stop Waiting to Be Asked: What Operators Really Need From Their Revenue Cycle Partners
The article argues that healthcare revenue‑cycle partners must shift from reactive "tell us what you need" approaches to proactive, anticipatory support. Operators juggling access, staffing, patient experience, and finances often lack the bandwidth to articulate needs during crises. By identifying...
How Tech-Enabled Independent Pharmacies Can Address America’s Medication Adherence Crisis
Medication non‑adherence still costs U.S. drug makers roughly $250 billion a year, despite billions spent on marketing. Independent pharmacies, which patients visit nearly twice as often as primary‑care doctors, are emerging as a critical touchpoint as chain stores close. New pharmacy‑focused...