A comprehensive new analysis from KFF has revealed that private insurers across the three largest government-funded or regulated health insurance markets—Medicare Advantage, Medicaid managed care, and the Affordable Care Act (ACA) Marketplace—denied millions of prior authorization requests in 2025, with denial rates reaching as high as 18% in some sectors. The report, which scrutinized data […]
Aligned Marketplace, a New York-based healthcare technology company specializing in advanced primary care solutions, has announced the successful closing of a $20 million Series A funding round. Led by prominent venture capital firm Venrock, this latest injection of capital brings the company’s total funding to $31 million. The investment is earmarked for the aggressive expansion […]
In a legal challenge that could fundamentally alter the financial and administrative landscape of the United States healthcare system, the nonprofit organization PatientRightsAdvocate.org (PRA) has filed a federal lawsuit against the American Medical Association (AMA). The lawsuit, filed in the U.S. District Court for the Northern District of Illinois, seeks to strip the AMA of […]
The Chicago-based telehealth provider NOCD has officially committed to a nationwide expansion of its virtual intensive outpatient program, marking a significant milestone in the delivery of specialized behavioral health services. By scaling its intensive outpatient therapy (IOP) across the United States, NOCD aims to address a long-standing deficiency in the mental health landscape: the lack […]
Unlimited Technology Systems, a prominent Ohio-based health technology vendor specializing in revenue cycle management, has officially disclosed a significant data breach that has compromised the sensitive personal and medical information of approximately 3.8 million patients. The incident, which has been confirmed as a targeted ransomware attack, highlights the escalating vulnerabilities within the healthcare supply chain, […]
Small business owners across the United States are facing a significant financial hurdle as health insurers propose a median premium increase of 14% for the 2027 plan year. This projection, detailed in a comprehensive analysis by KFF (formerly the Kaiser Family Foundation) and the Peterson Center on Healthcare, underscores a period of accelerating healthcare costs […]
The Centers for Medicare & Medicaid Services (CMS) has unveiled comprehensive details regarding the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway, a transformative initiative designed to expedite the availability of innovative medical technologies for Medicare beneficiaries. First introduced in April as a collaborative effort with the Food and Drug Administration (FDA), the […]
The American healthcare landscape is currently undergoing a significant technological transformation, driven by the rapid integration of artificial intelligence into the administrative and clinical workflows of major payers. In a recent detailed discussion on the MedCity Pivot Podcast, Nathan Frank, the Chief Digital and Technology Officer at Aetna, the insurance arm of CVS Health, outlined […]
The integration of artificial intelligence into the clinical workflow has reached a pivotal inflection point, moving beyond the initial novelty of digital scribing toward a more comprehensive automation of the healthcare administrative ecosystem. Ascension, one of the largest private healthcare systems in the United States, is currently spearheading a transition that seeks to eliminate the […]
The landscape of biotechnology initial public offerings has undergone a fundamental transformation in 2026, marking a definitive departure from the speculative frenzy that characterized the early 2020s. As the sector experiences a robust resurgence in public listings, a clear pattern has emerged: institutional investors are no longer content with preclinical promises. Instead, the market is […]
