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Over the past two decades, U.S. hospitals have absorbed nearly $745 billion in uncompensated care, according to the American Hospital Association. This burden continues to grow as hospitals struggle to verify active insurance. The task is made harder by patients frequently changing jobs, relocating and moving through a fragmented payer system that providers must track and…
Medical affairs teams are under pressure like never before, not only from the surge of healthcare data and expanding engagement demands, but from the constant challenge of proving their value to the C-suite. Data volumes in healthcare have exploded, while medical science liaisons are taking on more of the engagement once handled by sales. That…
Key takeaways: Healthcare organizations are facing growing levels of bad debt and a sharp decline in collections. Propensity-to-pay models that utilize machine learning and robust data offer insight into a patient’s likelihood to pay and allow staff to focus their collections efforts where they matter most. In 2024, Experian Health clients that implemented Collections Optimization…
Operating room capacity is a financial backbone for hospitals, but inefficiencies in this department often ripple outward — hurting operating margins, burning out clinicians and reducing patient access. On Thursday, a startup looking to fix operation room inefficiencies raked in a hefty Series B round. Healthcare data and AI platform Apella announced the close of…
Manual prior authorization workflows represent one of the most tedious and expensive aspects of the healthcare revenue cycle. However, despite access to automated prior authorization software, only 31% of providers use electronic prior authorizations, according to the Council for Affordable Quality Healthcare (CAQH). The CAQH predicts that providers who switch to automated prior authorization software…
At A Glance Claim scrubbing technology helps healthcare providers submit clean, accurate claims from the start – improving accuracy, reducing denials and maximizing reimbursements. Key takeaways: Claim scrubbing is a critical part of claims management, designed to improve claim accuracy and catch errors before submission. Errors on claims are a leading cause for denials and…
Suzy Lohman felt compelled to act when she learned that foster children treated at Cincinnati Children’s Hospital Medical Center often lacked proper bags for their belongings. Inspired by a hospital newsletter request for suitcases, duffel bags, and backpacks, Suzy launched a drive among EVS employees to collect these essential items. Many foster children, she knew, relied…
OpenEvidence has raised nearly $700 million since it was founded in 2021. Last month, the Miami-based company closed a $250 million Series D funding round that brought its valuation to a whopping $12 billion. What about the startup has so captivated investors? They point to OpenEvidence’s bottom-up, doctor-first model, which has prompted 757,000 doctors to…
Access to primary care is collapsing in the U.S., creating an opening for new models that lower costs and improve outcomes. This week, Premise Health and Crossover Health moved to capitalize on that opportunity, announcing an agreement to merge into a single company focused on scaling primary care access. The combined organization will provide onsite,…
Cancer care company Color Health is partnering with insurer Evry Health to enhance employer health plans with its cancer care services, according to a Wednesday announcement. Evry Health is a Texas-based insurer serving fully insured employers with 51 or more employees. Its plans have no traditional cost-sharing, including no co-pays and no deductibles, and provide…
