September 5th 2025
Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences.
Practical Considerations for AI in Community Oncology
July 8th 2025Artificial intelligence (AI) transforms oncology by enhancing decision-making, improving patient care, and streamlining operations, while addressing challenges in data accuracy and equity, said speakers at the Tennessee Oncology “Tech Innovations in Community Oncology."
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Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
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How AI Can Address the Troubled Business Model in Oncology
July 7th 2025Artificial intelligence (AI) will transform community oncology, addressing workforce shortages and reimbursement challenges while enhancing patient care and operational efficiency, discussed speakers at Tennessee Oncology's “Tech Innovations in Community Oncology."
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Without IRA Fix, COA Warns Community Oncology Practices Will Shut Down
June 30th 2025Ted Okon, MBA, of the Community Oncology Alliance discusses how community oncology faces a revenue crisis due to the Inflation Reduction Act's impact on Medicare reimbursement, risking patient access to vital cancer treatments.
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Supreme Court Decision on Braidwood Protects Insurance Coverage of Preventive Care
Published: June 27th 2025 | Updated: June 27th 2025The decision by the Supreme Court has major implications on which preventive services are required to be covered by insurance companies under the Affordable Care Act.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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Democratic Doctors Caucus Reaffirms EMTALA Amid Trump's CMS Policy Reversal on Abortion Care
June 18th 2025Democratic leaders assert the Emergency Medical Treatment and Labor Act (EMTALA) remains vital for emergency care, countering confusion from recent policy changes affecting abortion rights and patient safety.
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How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid
Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.
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Accessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.
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Use of Voluntary Alignment in the Next Generation ACO Model
Use of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.
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