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Medicare Advantage was sold as a smarter, more efficient way to care for seniors, but too often the efficiency seems to land on the wrong side of the patient–provider relationship. When plans deny or delay needed services through opaque rules and weak oversight, beneficiaries feel it first—in missed therapies, postponed procedures, and a…

Houston’s unmatched diversity and rapidly growing young population are reshaping the city’s economic future — and offering clues about what’s ahead for the nation. In the upcoming episode of Weaver: Beyond the Numbers, the conversation explores how immigration, education, and demographic momentum intersect to create extraordinary opportunities when supported with the right investments.

Behind the sterile labels of “inpatient” versus “observation” care is a messy reality: clinicians and insurers often enter peer-to-peer reviews without a shared rulebook, turning what should be a clinical dialogue into a box-checking exercise. The speaker’s frustration points to a broader problem in U.S. healthcare utilization management—decisions about coverage can feel pre-decided,…

A physician advisor recently described a case that should unsettle anyone who cares about fair, clinically grounded coverage decisions: a Medicaid patient arrived comatose from an overdose, was emergently intubated, developed aspiration pneumonia, and stayed through three midnights before leaving against medical advice. By any bedside standard, this is acute, unstable care—exactly what…