Podnosis

Dermatology may not be a specialty traditionally associated with high costs, but that is changing, in part because of the rise of new biologic drugs. Specialty medications are rapidly driving up dermatology spending, with some estimates showing utilization growing more than 30% year over year, a pace that rivals other high-cost therapeutic areas.

Could strong he...

Dual-eligible members are often described as the most complex population in health care, and many health plans continue to struggle with how best to support them. In this sponsored episode of Podnosis, Darin Buxbaum, co-founder and CEO of Wider Circle, joins host Chris Hayden to discuss why traditional engagement and enrollment models frequently miss the mark.

Buxbaum explains how a lack of trust, fragmented Medicare and Medicaid a...

The buzz around artificial intelligence in healthcare hasn’t waned, and for major companies to keep up, they must invest in key applications. For the biggest firms, that translates to hundreds of use cases in practice and testing.

At Elevance Health, that work is grounded in a key mantra: keep the member at the center. 

In this episode of "Podnosis," Senior Writer Paige Minemyer sat down with Ratnakar Lavu, chief digital...

Colorectal cancer rates are rising rapidly among young people worldwide. Experts expect it to become the leading cause of cancer death among people ages 20 to 49 by 2030. Younger patients are also more likely to be diagnosed at later stages.

In 2019, Dana-Farber Cancer Institute launched its Young-Onset Colorectal Cancer Center. The center is pioneering a specialized model of care to address and study the unique needs of younger ca...

With all the talk about generative AI over the past few years, the conversation in healthcare has largely shifted away from less flashy use cases, such as automating administrative tasks. But doing the basics well remains key to minimizing missed appointments, delayed treatments and lost revenue. 

PocketHealth automates nonclinical workflows for providers, from image release and scheduling to patient communication. Co-founder ...

On January 1, CMS launched its latest alternative payment model: TEAM, the Transforming Episode Accountability Model. The mandatory program requires hundreds of acute care hospitals to participate in episode-based payments for five common, high-cost surgeries.

TEAM's goal is central to value-based care: improve quality while reducing Medicare spending. But the model has faced industry resistance. Critics argue it puts smaller, less...

Employers are in a tough spot. Healthcare costs are rising, while insurance plan options may seem overwhelming or inadequate. The need for real value has never been more apparent. What if there were a way to optimize an existing provider network for quality?

Garner Health helps employers address these pain points. By finding the best-performing doctors in a given network and incentivizing members to see them, Garner claims to help ...

Since the Trump administration took office in January, healthcare policy has been moving quickly, with changes touching Medicaid funding, ACA subsidies, hospital finances and the federal government’s approach to health technology.

This week on "Podnosis," we’re bringing you a recording from a live roundtable at the Fierce Health Payer Summit on Dec. 4, ...

Each year, Fierce Healthcare’s Women of Influence special report asks a simple question: Who is actually reshaping healthcare from the inside? This year brought a record number of nominations and a list that reflects how broad that influence has become, across health systems, payers, tech, policy and advocacy.

In this...

It’s been a buzzy few years for prescription digital therapeutics, marked by bankruptcies, reimbursement policy changes and AI advancements. 

At their best, DTx solutions can offer a more personalized, convenient and cost-effective care experience. But barriers to adoption remain. What are they, and what’s being done about them? Senior Writer Anastassia Gliadkovskaya explores these questions with Joseph Perekupka, ...

Conduent is leaning into artificial intelligence to help clients navigate budget constraints, improve service quality and streamline operations, according to Mandy Huckaby, vice president and general manager of customer experience management.

Speaking on Fierce Healthcare’s Podnosis podcast, Huckaby said the company is focused on helping clients “do more with less” by integrating AI across customer-facing and back...

With the longest government shutdown in U.S. history as a backdrop, for-profit providers and payers detailed the continued regulatory uncertainty and pressures on their businesses in the third quarter. 

In this episode of "Podnosis," Editor Dave Muoio and Senior Writer Paige Minemyer break down the key trends for the third quarter, including how insurers shed light on strategic priorities, the impact of the ACA subsidy convers...

In a recent episode of Podnosis, Dr. Jerilyn Morrissey, chief medical officer at CorroHealth, called for a strategic overhaul in how hospitals approach clinical documentation and payer denials.

“Documentation has become the battlefield where clinical, financial and payer priorities collide,” Morrissey said. Tracing the evolution of medical records from ancient Egypt to modern electronic systems, she emphasized that whil...

Florida is among the fastest-growing states in the U.S. Demand for healthcare is also growing. Predicting community needs can help organizations be better prepared to serve patients.  

To understand what health systems in Florida are thinking about when it comes to architecture and design, Senior Writer Anastassia Gliadkovskaya talks to Michael Compton, director of healthcare, Florida, at Barge Design Solutions....

The hype around artificial intelligence in healthcare has yet to fizzle out. The technology offers a significant opportunity for healthcare organizations to reduce complexity and inefficiencies in the system. However, there are plenty of risks to navigate, too. 

In this episode of "Podnosis," Senior Writer Paige Minemyer sits down with Sandeep Dadlani, CEO of Optum Insight and former chief technology officer at UnitedHealth Gr...

In this sponsored episode of Podnosis, host Chris Hayden speaks with Dr. Jigar Patel, Chief Medical and Product Officer at Claritev, about one of healthcare’s biggest financial blind spots—revenue leakage.

Dr. Patel explains why hospitals often lose up to 15–25 cents of every revenue dollar through inefficiencies, under-optimized contracts, and fragmented data systems. He shares how lack of analytics expertise and...

There is a newer wave of middlemen in the self-insured market: alternative funding programs. 

The for-profit vendors claim to help employers save money on expensive specialty medications by obtaining them for free or at a steep discount through alternative sources. While they may sound promising, some healthcare experts describe them as sneaky, harmful to patients and in a gray zone ethically and lega...

Amid a breakneck pace of regulatory changes under the Trump administration, healthcare stakeholders are scrambling to keep up. Experts are sharing learnings and doing their best to understand how the policies of today affect the sector.

Senior Writer Anastassia Gliadkovskaya chats with two executives with a front-row seat to those conversations: Maria Ghazal, CEO of the Healthcare Leadership Council; and Robert Andrews, CEO of the ...

Millions of Americans are affected by cancer each year. For many, hair loss is among the most distressing side effects of chemotherapy treatment, causing some to put off or refuse chemo.

A revolutionary technology exists: scalp cooling, which involves wearing a cold cap during treatment to restrict blood vessels and reduce how much chemo reaches the hair follicles.

Rossalynn Ripper, a breast cancer survivor, was able to use scalp c...