Most payer teams can stand up a prior authorization API. They can: That part is doable. The trouble starts after go-live, when providers begin…
Healthcare
CMS Interoperability and Prior Authorization Final Rule for Payers
People are calling this an “API rule,” but that framing causes payers’ trouble. APIs are the visible output. The hard part is…
Population Health Analytics for Healthcare Payers
For healthcare payers, population health has shifted from an abstract ambition to a measurable responsibility. Outcomes influence reimbursement, quality ratings affect competitiveness,…
Value-Based Healthcare: How Integration and Data Drive Better Outcomes
The Push to Redefine Value in Healthcare What if hospitals were rewarded for keeping people healthy rather than for performing…
Integrated Healthcare Delivery Systems: The Next Stage of Coordination
Healthcare has never lacked data or expertise — it has struggled with connection. A patient might see three specialists, visit…
Healthcare Payer Analytics: How Data-Driven Payers Are Controlling Cost, Risk, and Outcomes
For many healthcare payers, the most difficult conversations rarely begin with technology. They begin with misalignment. Finance teams track rising…
How Data Analytics Changing Healthcare Delivery Systems
Healthcare delivery is under growing pressure. Hospitals and clinics are caring for aging populations with complex needs while budgets and…
Types of Healthcare Delivery Systems
Healthcare delivery has always revolved around one challenge: how to bring the right care to the right person at the…
14 ICD Myths Healthcare Leaders Must Stop Believing in 2025
Why ICD Still Trips Leaders Up For something as established as the International Classification of Diseases, you would expect smooth…
What Is TEFCA and Why It Matters for U.S. Healthcare
For years, the promise of health data interoperability has felt just out of reach. Despite a growing network of EHR…
SMART on FHIR: The Foundation for Healthcare App Integration
Why Your Patient App Fails When It Reaches the EHR You’ve built a sleek patient app. It checks all the…
Transparency in Coverage Rule & Consolidated Appropriations Act: 2025 Updates & Compliance Guide
The Transparency in Coverage (TiC) Rule and the Consolidated Appropriations Act (CAA) were introduced to make healthcare pricing clearer for…