For payer organizations, the new CMS prior authorization final rule isn’t a simple compliance checkbox. It’s a real-time audit of...
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...