Season 5 – Gossip About Gossip

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…

Insurance denials aren’t new, but they’re hitting a breaking point right now. As prior authorizations surge and patients face longer delays for everything from imaging to specialty drugs, more providers are realizing that the “payer” on the card often isn’t the one truly holding the reins. A growing share of Americans are covered…

More and more hospital environments rely on continuous, high-quality data to support faster clinical decisions, but much of today’s patient monitoring still varies widely by unit, device, and workflow. This episode kicks off a five-part Health and Life Sciences at the Edge series exploring The Future of Patient Monitoring. Intel’s Kaeli Tully, Solutions Engineer…