Thu.Jan 16, 2025

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What Payers Need to Know to Stay Ahead in 2025

MRO Compliance

2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Payers face increasing regulatory demands, heightened expectations for interoperability, a renewed focus on payment integrity, and rising pressure to address health equity. These changes can feel daunting, but with the right tools and strategies, payers can thrive, innovate, and build stronger partnerships.

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DEA plans to create a special telehealth registration for prescribers

Healthcare IT News - Telehealth

The U.S. Drug Enforcement Agency has released its notice of proposed rulemaking for a framework to permit medically necessary controlled substances without an in-person visit without violating the Ryan Haight Online Pharmacy Consumer Protection Act. WHY IT MATTERS The NPRM comes two months after the DEA and U.S. Health and Human Services announced they extended the pandemic-era virtual prescribing of controlled substances a third time.

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UnitedHealth reaches record revenue in 2024, though profit falls

Healthcare Dive

UnitedHealth’s net income plummeted to its lowest level since 2019 amid hefty costs, including some from the Change cyberattack. CEO Andrew Witty also remembered slain executive Brian Thompson on a Thursday morning call.

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Apollo Hospitals to integrate AI copilots and more AI briefs

Healthcare IT News - Telehealth

Apollo Hospitals to adopt AI copilots from Microsoft Apollo Hospitals will be adopting four AI copilots as part of its new collaboration with Microsoft. In a statement, the technology giant said it will help the hospital group develop and implement its AI roadmap, which will focus on expanding Apollo's remote healthcare platform worldwide and building new technology solutions.

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How to Start Virtual Care the Right Way: A Proven Roadmap for 2025 and Beyond

Speaker: Dr. Christine Gall, DrPH, MS, BSN, RN

The promise of virtual care is no longer theoretical and is now a critical solution to many of healthcare’s most urgent challenges. Yet many healthcare leaders remain unsure how to build a business case for investment and launching the right program at the right time can be the difference between value and failure. For organizations seeking a financially sound, clinically effective entry point, Virtual Patient Observation (VPO) offers a compelling case to lead with.

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24 Executive Healthcare AI Predictions & Trends to Watch in 2025

HIT Consultant

From AI-powered diagnostics to personalized medicine, we asked twenty four healthcare executives their insights on trends and technologies that will transform patient care in the coming year. Ashley Barrow, Founder and CEO of RE-Assist In 2025, Artificial Intelligence and the T.E.A.M. (Transforming Episode-Based Accountable Management) model will redefine care coordination, creating a smarter, faster, and more equitable healthcare system.

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Century Health to Curate Real World EHR Data for MS Research and Treatments

HIT Consultant

What You Should Know: – Century Health , a provider in applying artificial intelligence (AI) to real-world data for research acceleration, and Nira Medical , a national leader in neurological care delivery, announced a strategic partnership to advance the understanding of multiple sclerosis (MS) and improve patient outcomes. – The collaboration will leverage Century Health’s AI platform to curate and structure data from over 3,000 MS patients treated within Nira Medical’s

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OCR Settles With Northeast Surgical Group, P.C. over Potential HIPAA Risk Analysis Rule Violation

Compliancy Group

In mid-January of 2025, the Department of Health and Human Services Office for Civil Rights announced a $10,000 settlement agreement with Michigan-based Northeast Surgical Group, P.C. (NESG). The agreement requires NESG to submit to two years of OCR monitoring, in the form of a corrective action plan (CAP). NESG agreed to settle allegations of noncompliance with the HIPAA security risk analysis violation.

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Digital health funding falls again in 2024: Rock Health

Healthcare Dive

Investors focused their dollars on younger startups, while deal sizes for more established companies declined last year.

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CMS Behavioral Health Billing Guidelines: Simplified for Outpatient Providers

Medisys Compliance

Behavioral health providers play a critical role in addressing mental health challenges, but navigating the complexities of billing can be daunting. The Centers for Medicare & Medicaid Services (CMS) provides comprehensive behavioral health billing guidelines, which can be overwhelming due to their technical nature and breadth. To assist outpatient behavioral health providers, weve extracted the key CMS billing guidelines related to your daily operations, offering a detailed look at the most

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How to Turn “Check-the-Box” Compliance Trainings Into Real Learning

Speaker: Brian Richardson, Brian Richardson, Founder and CEO of Richardson Consulting Group

Let’s face it—most ethics and compliance training programs aren’t winning awards for engagement. But that doesn’t mean they can’t be effective, captivating, and maybe even enjoyable! Join learning design expert Brian Richardson for a dynamic session on how to breathe new life into your ethics and compliance training. We'll explore innovative strategies to bring traditionally dry topics to life, making them resonate with learners and drive tangible change.

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Pushing Forward Healthcare Interoperability Efforts by The Sequoia Project in 2025

Healthcare IT Today

New guidelines for health care privacy and consent, extending data sharing to new types of organizations, ensuring the clinical usability of data, and just lots and lots of growththese are on the agenda of The Sequoia Project in the upcoming year. In this video, CEO Mariann Yeager concisely explains in this interview their recent achievements, how they work with the ONC and other stakeholders on TEFCA and QHINs, and some of their upcoming plans.

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Fierce Healthcare - Untitled Article

Fierce Healthcare

UnitedHealth Group reported $5.5 billion in profit for the fourth quarter of 2024, on par with its haul a year prior. | UnitedHealth Group reported $5.5 billion in profit for the fourth quarter of 2024, on par with its haul a year prior.

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Scripta Insights Secures Series B Funding, Raises $42M Total, Revolutionizing the Way Americans Shop for Prescription Drugs

Healthcare IT Today

$17M Series B Round Led by Aquiline to Fuel Scriptas Growth into Health Plan and Medicare Advantage Markets Consumerism in healthcare is a popular catchphrase, but when it comes to prescription drugs, Americans are lacking the transparency, clinical expertise, and navigation tools needed to make informed decisions. Thats the problem that the AI-powered pharmacy navigation platform, Scripta Insights , is on a mission to solve, starting with the 105 million Americans who are on self-insured plans.

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Digital Health Coffee Time Briefing ☕

Digital Health News

Our latest news roundup includes new Beckman Coulter analysers for Croydon Hospital and a digital inclusion initiative for pregnant women.

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The Essential Guide to Secure Messaging in Healthcare

Discover everything healthcare providers need to know about secure messaging. Covering essential topics like HIPAA compliance, communication efficiency, and patient privacy protection, this resource is indispensable for professionals, caregivers, and administrative staff alike.📱 💬 Whether managing sensitive patient data, coordinating care teams, or streamlining workflows, discover actionable insights to implement secure messaging solutions effectively.

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Instrument Processing Essentials: Key Steps for Sterilization and Storage

Total Medical Compliance Resources

Instrument processing is critical to ensure sterility of instruments utilized on patients. There are four steps in processing instruments: cleaning, packaging, sterilization, and storage. This article will focus on the last two steps: sterilization and storage. Earle H. Spaulding. PhD, devised a rationale for disinfection and sterilization of instruments and items.

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The Detrimental Impact of Tech Debt in the Healthcare and Life Sciences Industries

Healthcare IT Today

The following is a guest article by Mindy Herman, Managing Principal, Health & Sciences at Crowe , and Jasmine Fransen, Consulting at Crowe Medical devices are foundational components to providing exceptional patient care and helping healthcare and life sciences organizations achieve amazing feats of discovery, research, and problem-solving to save and improve lives.

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Security Changes in the Wind

HealthIT Answers

By Matt Fisher - On January 6, 2025, the Department of Health and Human Services officially published a notice of proposed rulemaking to modify and update the HIPAA Security Rule. The timing of the proposed rule leaves any sort of immediate action with a lot of uncertainty (changing administrations bring changing priorities and delays). The post Security Changes in the Wind appeared first on Health IT Answers.

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The Helix Research Network Adds 3 New Health System Members

HIT Consultant

What You Should Know: – Helix , a population genomics and precision health company, announced a significant expansion of its research network with the addition of three prominent health systems: TriHealth , Parkview Health , and Rochester Regional Health. – Each system has committed to enrolling 100,000 participants, bringing the total number of participants in the Helix Research Network to over 300,000, making it the largest and fastest-growing precision clinical research network gl

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Can Your Organization Spot a Conflict Before It’s a Crisis?

Speaker: Amie Phillips Pablo, VP, Corporate Compliance & Privacy Officer at Novo Nordisk

In today’s complex healthcare environment, navigating third-party relationships has become even more challenging—whether it’s vendor relationships, employee activities, or patient-facing interactions. Left unmanaged, these conflicts can compromise trust, regulatory compliance, and even organizational reputation. So, how can healthcare teams stay ahead?

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Fierce Healthcare - Untitled Article

Fierce Healthcare

About 44 million people were covered under one of the Affordable Care Act's initiatives, from the insurance marketplaces to Medicaid expansion, according to a new report from KFF.

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TetraScience & Microsoft Partner to Advance Scientific AI in Biopharma

HIT Consultant

What You Should Know: – TetraScience , a provider of scientific data cloud solutions announced a strategic collaboration with Microsoft to accelerate the adoption of artificial intelligence (AI) in the biopharmaceutical industry. – The strategic partnership combines TetraScience’s Scientific Data and AI Cloud with the power and security of Microsoft Azure , creating a robust platform for scientific organizations to extract valuable insights from their complex experimental data.

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Fierce Healthcare - Untitled Article

Fierce Healthcare

The cancer mortality rate dropped by 34% from 1991 to 2022. This saved about 4.5 million lives. Still, incidence rates in women between ages 50 and 64 have surpassed men, and rates in women under 50 are 82% higher than in men.

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Guardant Health and ConcertAI Partner to Unlock Cancer Insights with Multi-Modal Real-World Data

HIT Consultant

What You Should Know: – Guardant Health , a provider in precision oncology, and ConcertAI , a real-world evidence (RWE) and AI technology company in oncology, announced a strategic collaboration that will provide biopharmaceutical companies with access to a first-of-its-kind multi-modal real-world data (RWD) solution. – The partnership integrates comprehensive patient electronic medical record (EMR) data with genomic and epigenomic tumor profiling information, offering a deeper under

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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Fierce Healthcare - Untitled Article

Fierce Healthcare

Alignment Healthcare is the latest Medicare Advantage (MA) insurer to accuse the Centers for Medicare & Medicaid Services (CMS) of wrongly calculating the companys star rating scores. | Insurers, perhaps smelling blood in the water, continue to question elements and scoring of the CMS star ratings program in court.

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Oncology: Caris and Ontada Combine Data to Drive Precision Medicine

HIT Consultant

What You Should Know: – Caris Life Sciences (Caris) , a pioneer in precision medicine and next-generation AI TechBio innovation, announced a transformative collaboration with Ontada , a leading organization in oncology real-world evidence, clinical education, and point-of-care technologies. – This partnership aims to advance cancer research, enhance healthcare delivery systems, and drive precision oncology through groundbreaking molecular research, data-driven solutions, and innovati

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Health IT Business News, Financial Edition – January 16, 2025

HealthIT Answers

Business and financial news from Waystar, Inovalon, Infinx Healthcare, FIRE1, Biofourmis, ONRAD, Red Rover Health, MDaudit, Encore Exchange, Tendo, CirrusMD, Omega Healthcare, Transcarent, Peerbridge Health, Brightside Health, OnMed, Machinify, Hallmark, SuperDial, and more. The post Health IT Business News, Financial Edition – January 16, 2025 appeared first on Health IT Answers.

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Core Sound Imaging Secures $80M for Medical Imaging Platform

HIT Consultant

What You Should Know: – Core Sound Imaging , the company behind the innovative medical imaging platform Studycast , today announced a $80M growth investment from PSG , a growth equity firm. – The funding will accelerate Studycast’s mission to modernize medical imaging and improve patient care by expanding its reach within core specialties, entering new clinical areas, and enhancing AI capabilities.

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HIPAA Compliance 2025: Navigating Regulatory Changes & Industry Trends

Based on comprehensive survey data from diverse healthcare providers, the 2025 HIPAA Benchmark Report delivers actionable intelligence for modern compliance programs. This report examines how organizations are restructuring HIPAA Privacy Programs to address emerging regulatory requirements. Through analysis of staffing models, program operations, and breach management protocols, it provides a clear picture of current best practices.