MedCity News

Massachusetts Attorney General Sues UnitedHealthcare, Alleges $100M MassHealth Fraud

Are We Measuring Metabolic Health All Wrong?

A fragmented system built on isolated metrics like BMI and A1C fails to capture the full picture of metabolic health and limits our ability to manage it effectively.

By Richard Frank

MedCity Influencers

Scaling AI in Health Systems: From Innovation to Sustainable Implementation

By adopting interpretation-driven, clinically intelligent technologies, revenue cycle teams can ensure that every nuance of care is accurately represented. This safeguards revenue integrity while maintaining the highest standards of compliance.

By Hari Bala

MedCity Influencers

Digital generated image of multi layered dollar sign making swirl pattern.

The Most Expensive Queue in Healthcare Isn’t Prior Auth — It’s the IT Backlog

Every month a legitimate workflow improvement sits in queue, the organization pays for the problem twice: once in the inefficiency the change was supposed to fix, and again in the workaround everyone built to get through the week. The backlog doesn’t show up as a line item. It shows up everywhere else.

By Fawad Butt

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Payers

Why Ob-Gyns, States, and Plans, Should Care About Oral Health

While there are growing efforts to link dental health with overall health, the urgency should be felt strongly not only by pregnant women but, more importantly, by their care providers and health insurance companies. For instance, pregnant women with gum disease are 3-4 times more likely to develop pre-eclampsia, an emergency condition.

By Arundhati Parmar

BioPharma, Pharma

Regeneron Cancer Drug Shows New Promise in a Rare Disease… and Maybe More

Regeneron Pharmaceuticals’ multiple myeloma drug linvoseltamab has clinical trial results showing complete responses in 90% of patients who have light chain amyloidosis, a rare blood disease. The preliminary data were presented during the annual meeting of the American Society of Clinical Oncology.

By Frank Vinluan

The Power Behind Enterprise EHR Software for Large Healthcare Systems

Enterprise EHR boosts scalability, interoperability, and governance for large healthcare systems.

By Malvika Tarnekar, Director of Product Strategy, PrognoCIS by Bizmatics Inc

Artificial Intelligence, Startups, Devices & Diagnostics

Glucose control. Positive African American man with sensor patch monitor on arm, measuring sugar levels using app

Signos Secures $20M to Expand CGM Use Beyond Diabetes Into Weight Loss

Signos raised $20 million to expand its glucose monitoring platform for weight loss, which pairs Dexcom’s over-the-counter CGM with an app that translates glucose data into personalized diet and lifestyle recommendations.

By Katie Adams

Health Tech

Businessman hanging big coin on much more paid money coins and less small income coin. concept of pay gap, inequality between man and woman wage, salary or income, issue about gender diversification

4 Notable Health Tech Funding Announcements in May

Health tech companies made several major funding announcements in May. Here is a list of some of the biggest funding rounds.

By Marissa Plescia

MedCity Influencers

Telehealth is Making GLP-1s More Accessible – But Access Alone isn’t Enough

Providing access to GLP-1s only solves part of the problem. In fact, without a broader approach, it may lead to new challenges alongside the ones it aims to address.

By Ro Huntriss

The Hidden Administrative Tasks Draining Small Practices

Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.

By Michael Blackman, MD, MBA Chief Medical Officer, Greenway Health®

MedCity Influencers

Medical Education Is at a Crossroads. AI Isn’t the Problem — It’s the Mirror

The real question is whether we're being honest with ourselves about what medical education was designed to produce, and whether our current system is still doing that job.

By Dr. Michael Jerkins

MedCity Influencers

Preparing Benefits For the Next Wave: Gene Therapy Medications

The rise of metabolic gene therapies represents a critical juncture for benefits management. These treatments offer genuine hope for patients with serious conditions, but they also pose significant financial challenges.

By Katherine Shanahan

Devices & Diagnostics, Startups, Pharma, Health Tech, Providers

Healthcare Moves: A Monthly Summary of Hires, Exits and Layoffs

May has seen a slew of executive hires, exits and layoffs across the healthcare industry. For instance, Abridge, Highmark Health and Merck named new executives. There were also layoffs at organizations including Innovaccer, Intermountain Health and Novartis.

By Katie Adams

BioPharma, Pharma

Pfizer’s $10.5B Deal With One of China’s Top Cancer Biotechs Is Another Sign the Game is Changing

Pfizer unveiled a multi-drug R&D collaboration with Innovent Biologics, making it the latest big pharma company to reach a deal that taps into Chinese labs to source biotech innovation. This alliance will focus on developing next-generation drugs in the class of targeted cancer therapies called antibody drug conjugates.

By Frank Vinluan

Health Tech

Garner Health Secures $100M to Connect Patients with High-Performing Doctors

Garner's Series E round was led by Index Ventures with participation from Kleiner Perkins, Redpoint, Thrive, Sequoia, Founders Fund and Kaiser Permanente Ventures.

By Marissa Plescia

MedCity Influencers

The EHR Was Built to Store Data — It Wasn’t Built to Orchestrate Care

The next evolution in digital health is layering intelligent orchestration on top of the EHR to activate care in real time. It’s a platform plus orchestration layer, powered by AI and designed for action.

By Jonathan Bush

MedCity Influencers

The Illusion of Visibility: Why More Data Doesn’t Mean Better Decisions

When every metric is treated as important, nothing actually stands out. Leaders spend more time interpreting data than acting on it. And in a system as complex as healthcare, delays in decision-making can have real operational and financial consequences.

By Deb Jones

MedCity Influencers

Aging is Soon to Be a Preventable Disease

For most of human history, cellular aging was treated as biologically fixed, an inevitable accumulation of damage with no meaningful pathway to reversal. That assumption is no longer tenable.

By Boyang Wang

Health Tech

Walmart, Teladoc Team Up to Expand Access to Virtual Care

Through a new partnership, Teladoc Health's virtual services are now available on Walmart's Better Care Services platform.

By Marissa Plescia

Hospitals, Policy, Payers, Providers

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CMS Finalizes Rule to Simplify Payer-Provider Disputes Under No Surprises Act

CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improve transparency.

By Katie Adams