Articles

Prior Authorization May Result in Lower Insurance Payouts and Better Patient Outcomes

Prior Authorization

Prior authorization is an essential component in the healthcare provider and insurance provider relationship. Melanie Musson, a health insurance expert with InsuranceProviders.com, reminds providers, “Prior authorization can save companies millions, but streamlined processes are critical to a positive experience.” AHIP recently published research findings that indicate the importance of prior authorization. It can prevent…

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From Finance to the Future of Cardiac Innovation: Ken Nelson on Building, Leading, and Investing in MedTech

Over the past two decades, digital health has evolved from a niche concept to a cornerstone of modern care—especially in cardiology, where MedTech innovations like remote monitoring and wearable devices are redefining how patients are diagnosed and managed. Yet behind every billion-dollar breakthrough is a leader who knew how to commercialize it. As cardiovascular startups…

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The Rise of Personalized Nutraceuticals: Vitaquest Taps Big Data, Flavor, and AI to Deliver Personalized Wellness at Scale

The wellness industry is at an inflection point. What once centered around pill packs and generic supplement regimens is now being transformed by an ecosystem of personalization, flavor innovation, and data-driven development. According to research, the global nutraceuticals market is on track to surpass $919 billion by 2030—and with consumer demand increasingly favoring tailored,…

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2025’s Hottest Healthcare Trends with David Willis, Principal with ECG

Healthcare organizations have faced significant challenges over the last five years due to the lasting financial and operational impacts of the COVID-19 pandemic, widespread labor shortages, and rising costs of care delivery. The pandemic forced hospitals to prioritize crisis response over long-term strategy, leading to deferred investments, workforce burnout, and financial strain. Now, with many…

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Private Equity and Venture Capital Are Transforming Healthcare – But at What Cost?

Private equity and venture capital have been reshaping the healthcare landscape, with $47 billion in related deals recorded from 2019 to 2023. These investments promise innovation and growth in AI, diagnostics, and healthcare delivery. However, they also raise critical questions about aligning profit-driven goals with the mission to improve patient care and system efficiency….

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Solving America’s Physician Shortage Through Apprenticeship Programs, Online Training & Hands-On Experience

In a healthcare landscape reshaped by post-pandemic challenges, workforce shortages and burnout are stretching the system to its limits. According to the Association of American Medical Colleges, the U.S. is projected to face a shortage of up to 86,000 physicians by 2036, while turnover rates among nurses and allied health professionals continue to climb….

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AI-Powered Remote Cardiac Monitoring Improves Care Access, Disease Detection, and Diagnostic Accuracy

Advancements in artificial intelligence are transforming healthcare, and remote cardiac monitoring is at the forefront of this change. With cardiovascular disease impacting nearly 50% of the population at some point in their lives, early detection and efficient diagnosis are crucial. Enter AI-powered cardiac monitors that provide near real-time data, reduce diagnostic errors, and improve…

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pcp
PCP Attribution Analysis
May 22, 2025

Dr. Sam Ambewadikar, RVP and Medical Director at Anthem National Accounts, joins Brent to unpack the power of primary care attribution analysis—a tool he helped pioneer to spotlight the clinical and financial impact of members not having an established PCP. Drawing from his background as a practicing pediatrician and claims analytics leader, Dr. Sam shares…

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sydney health
Sydney Health Demo
May 22, 2025

In this episode, Christina Firouztash, Executive Advisor of Digital Solutions at Anthem, gives a dynamic walkthrough of the Sydney Health app—Anthem’s flagship digital member experience. Christina showcases how Sydney delivers personalized, simple, and equitable navigation across benefits, including virtual care, pharmacy, financial transparency, and social services access. From contextual chatbots and ID card access to…

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pharmacy
Pharmacy Part 1
May 22, 2025

In this episode, Brent chats with Katie Brennan, National Sales Director at CarelonRx, about making pharmacy benefits more accessible, consistent, and member-friendly. Katie spotlights Carelon new advanced home delivery model, which brings the pharmacy counter—and the pharmacist—into the member’s home. With fewer retail pharmacies offering extended hours and many patients lacking reliable transportation, CarelonRx is…

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inclusive care
Inclusive Care
May 22, 2025

Sammy Gonzalez, Regional Vice President at Elevance Health, joins Brent for a deeply personal and impactful conversation on health equity and inclusive care. Sammy shares a powerful story of medical misdiagnosis tied to cultural assumptions, underscoring how bias—even unintentional—can hinder care quality. He highlights Elevance’s work to improve diversity in provider networks, enhance cultural competency,…

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Other Articles
HFMA’s Historic New Leaders: The Trailblazing Women Who Are Leading Healthcare Finance
December 18, 2024

For the first time in history, Texas is home to three female presidents leading Healthcare Financial Management Association (HFMA) chapters, alongside the organization’s first female CEO, Ann Jordan. This unprecedented moment is more than symbolic; it highlights a shift toward inclusivity, collaboration, and innovation in healthcare financial management. With Texas chapters spanning diverse regions…

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Improving Healthcare Access Through Nontraditional Benefits and Discount Plans
November 19, 2024

Healthcare costs are rising steadily, while insurance benefits struggle to offer sufficient coverage, driving demand for practical solutions like nontraditional benefits and discount plans. As premiums rise and coverage limits remain stagnant, many individuals and employers seek alternative ways to manage costs and improve healthcare access. With chronic conditions on the rise, the stakes…

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Fighting for Fair Healthcare Access Means Overcoming Certain Challenges
November 8, 2024

With healthcare costs continuing to climb, and the access to quality care remaining uneven, discussions on healthcare reform are quite an essential topic. Millions of Americans face high out-of-pocket costs and limited access to critical health services. According to a 2022 Gallup poll, nearly 40 percent of Americans have delayed medical care due to…

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Resilience and Overcoming Challenges is a Goal to Aim For
October 28, 2024

Conversations around mental resilience and maintaining a positive mindset are increasingly relevant today. With rising levels of stress and burnout in both personal and professional spaces, many people are searching for ways to reframe challenges as opportunities. One study showed that 75 percent of employees reported feeling overwhelmed or burned out at work, underscoring…

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Elevating Home Care — A New Era of Partnerships and Collaboration
October 25, 2024

As the demand for home-based care continues to surge, the industry faces an urgent need to redefine its collaborative frameworks, particularly between clinical and non-clinical services. A growing body of research suggests that coordinated home care can reduce hospitalization rates, lower costs, and increase patient satisfaction—an impact felt across families, caregivers, and the healthcare…

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Shifting Our Mindsets to Transform Our Lives with Dr. Wendi Zimmer
October 22, 2024

The pressure to balance personal well-being and professional success is something we all face, but most of us don’t know where to start. Research has shown that mental health support and self-belief are critical for long-term success, especially in high-stress environments. Shifting your mindset can be the key to transforming your life, enabling you…

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Purpose in the Workplace: Retaining Talent Through Innovation, Engagement, and a Sense of Belonging
October 15, 2024

A surge in employee turnover and changing expectations in the workforce has made the pursuit of purpose in the workplace a priority. With an increasingly mobile workforce, retaining top talent has become a challenge that companies can’t afford to ignore. A study shows that roughly 70% of employees believe their sense of purpose is…

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Navigating Clinician Burnout and Nursing Shortages with Dr. Megan Carter
October 15, 2024

Clinician burnout and nursing shortages have reached critical levels, threatening the stability of healthcare systems nationwide. With projections indicating that Texas will be second in the nation for registered nurse (RN) shortages by 2030, the pressure on healthcare providers is intensifying. According to the National Council of State Boards of Nursing, around 100,000 registered…

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Demystifying Self-Funded Benefits Can Forge a New Path for Employers
October 2, 2024

Healthcare costs are skyrocketing in the U.S., placing significant pressure on both businesses and individuals. With health insurance premiums on the rise, businesses are searching for innovative solutions to manage these escalating expenses. As traditional fully-insured models become less sustainable, more employers are turning to self-funded benefits as a way to take control of…

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