The Business Side of Healthcare Blog
Discover comprehensive articles about the business side of chronic disease, medical advances, news and technology for health plans, providers, and employers
Articles
AI Radiology: Speed vs. Accuracy Tradeoff
AI is reading scans faster. But is it reading them better? The radiology world is celebrating speed. AI triage tools now flag critical findings in seconds. Worklists are getting prioritized. Turnaround times are dropping. And ...
CMS 340B Cut: $4.85B Hospital Shock
🏥 Washington just dropped a $4.85 billion bomb on hospitals. CMS released it on July 2. Most people are still catching up. 📋 Here is the scene. CMS issued a proposed rule for Calendar Year ...
Elevance $342M MA Overbilling Settlement
I keep thinking about one number this week: $342 million. That is the wire transfer Elevance Health sent to CMS on May 27. Disclosed in a June 22 court filing. Paid to settle allegations of ...
Medicare Advantage Denial Rates Are a Scandal
CVS denied 80% of Medicare post-acute care. That is not a glitch. Let me say that again. Eighty percent. 🚨 The Medicare Rights Center published data this week showing that the largest Medicare Advantage organizations ...
Cadence: AI Agents for Chronic Care
56 million older adults in this country live with chronic disease. Heart failure. Hypertension. Diabetes. Conditions that demand daily attention, medication adjustments, and real-time clinical judgment. We do not have enough clinicians to deliver that. ...
FQHC Funding: Bandage on a Wound
I keep thinking about this headline from this week. "New Rural Health Funding Only a Bandage for Medicaid Wound." That is not hyperbole. That is the operating reality for every FQHC and community health center ...
Gen AI Drafts Radiology Reports
I keep thinking about what happened this week in radiology. The FDA granted Breakthrough Device Designation to two generative AI tools that do not just detect findings on a chest X-ray. They draft the radiology ...
Medicare GLP-1 Bridge Program
Medicare just did something it has never done before. 🚨 I keep thinking about what this actually means. Starting July 1, 2026, CMS is launching the Medicare GLP-1 Bridge Program. For the first time in ...







