For payer organizations, the new CMS prior authorization final rule isn’t a simple compliance checkbox. It’s a real-time audit of...
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Optimizing Care Management with Automated Workflows
In today’s complex healthcare landscape, effective care management requires seamless coordination across multiple disciplines, including care management, utilization management, care...
Medicare Advantage: Can At-Risk Models Deliver Better Care?
A recent study published in JAMA Network Open suggests that physician groups operating under at-risk Medicare Advantage (MA) payment models...
Leading and Managing Medicare Shared Savings Programs in a Time of Transition
For healthcare organizations and providers involved in a Medicare Shared Savings Program (MSSP), 2025 is truly a time of transition...