The nonprofit organization is digitizing standards for quality care called HEDIS measures using CQL language, says Edward Yurcisin, NCQA’s chief technology officer.  

While data breaches affect all industries, healthcare suffers the largest financial hit, according to data compiled by the Ponemon Institute. This year, the average cost of a data breach reached an all time high of $4.4 million. That’s a 2.3% increase from 2022, and taking the long-term view, the average cost has increased 15.3% from […]

Subsidiaries of Franklin, Tennessee-based Community Health Systems have agreed to sell three Florida hospitals to Tampa General Hospital in a deal estimated to be worth $290 million, with the transaction expected to close later this year. The hospitals are 120-bed Bravera Health Brooksville in Brooksville, 128-bed Bravera Health Seven Rivers in Crystal River and 124-bed […]

The departments of Labor, Health and Human Services and the Treasury have proposed new rules meant to better ensure that those seeking coverage for mental health and substance use disorder can access treatment more easily – as easily as, say seeking coverage for medical treatments.

While AI can generate content there’s no good way yet to vet it, says Freddie Feldman, director of voice and conversational interfaces at Wolters Kluwer.

At least 3.6 million Medicaid enrollees have been disenrolled as of July 24, according to KFF data from 37 states and the District of Columbia.

Hospitals have been acquiring ambulatory care centers at a decent clip in many markets, and this could have a detrimental effect on consumers’ premiums and out-of-pocket spending due to the resulting outpatient facility fees, according to a new report from Georgetown University.

Greg Miller, chief growth officer at Lumeon, said the care environment is ripe for change and that automation can help with short staffing and alleviate costs.

Cigna is being sued for using algorithms to allegedly deny claims. The lawsuit, filed Monday in federal court in California, claims Cigna developed an algorithm known as PXDX to enable its doctors to automatically deny payments in batches of hundreds or thousands at a time for treatments that do not match certain preset criteria. This […]

Claiming that its old policy statements no longer reflect current market dynamics, the Federal Trade Commission has voted to rescind its prior statements of advocacy for pharmacy benefit managers, effectively ending the agency’s previously stated endorsement of PBMs. According to the FTC, the new statement pulling its advocacy is a response to PBMs’ continued reliance […]