Sponsored Sites
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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Autonomous Coding
Solventum
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RCM Management
ZOLL Data Systems
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
View All Episodes
Latest News
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How are states preparing for Medicaid work requirements?
A recent KFF report outlined the variable strategies states have adopted to implement Medicaid work requirements, ranging from enforcement to IT adoption.
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Payers promise standardized electronic prior auths
After announcing an 11% reduction in prior authorizations, major payers are now focusing on standardizing an electronic request process.
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CMS accelerates Medicare coverage for breakthrough medical devices
The agency and FDA announced a new Medicare coverage pathway for certain breakthrough medical devices that cuts the reimbursement timeline from 1+ years to months.
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CMS benches BALANCE Model for Medicare
The federal agency announced an indefinite delay to the Medicare Part D portion of the upcoming model that would expand coverage criteria for GLP-1s.
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UnitedHealthcare eliminates prior authorization for rural providers
In addition to scrapping prior authorization, UnitedHealthcare said it will speed up payments and create more community-based care models for rural providers.
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Mental health parity remains elusive in 43 states
In-network mental healthcare is harder to get in most states than physical healthcare, potentially due to disparate provider reimbursement rates.
Features
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5 healthcare pros on the trends defining primary care
The 2025 Payer + Provider Virtual Summit explored AI, value-based care and community-based partnerships, offering strategies on how to promote primary and preventive care.
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How payers can regain consumer trust via personalized care
Creating personalized health plans is central to regaining consumer trust. To do that, payers must outline safeguards for member data and create seamless experiences.
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With trust low and costs high, do payers stand to lose members?
Healthcare payers might see fewer enrollments as members face higher prices for a product they don't trust or see as high value.
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Breaking down the ABCs of rising alternative health plans
More employers are seeking alternative health plans, like AHPs and ICHRAs, to bend the cost curve, but education is key to navigating their growing popularity.













