Navigating the CMS Prior Authorization Final Rule: What Health Plans Need to Know

In January 2024, the Centers for Medicare & Medicaid Services (CMS) finalized sweeping new rules aimed at improving the prior authorization process. These changes, set to take effect starting in 2026, will require most health plans to fundamentally rethink how they manage authorizations, interoperability, and member communication. For health plans—including Medicaid managed care organizations (MCOs),… Continue reading Navigating the CMS Prior Authorization Final Rule: What Health Plans Need to Know

The Future of Medicare Advantage: Finding the True North with AI and Innovation

The Medicare Advantage (MA) landscape is evolving rapidly, carrying significant implications for providers, payers, and beneficiaries alike. In a recent webinar titled The Future of Medicare Advantage in the Trump Transition – Will AI Help Pave the Way?, InfoMC Board Member and renowned population health expert Dr. David Nash joined fellow industry leaders from the… Continue reading The Future of Medicare Advantage: Finding the True North with AI and Innovation

Navigating the Future of Healthcare: A Strategic Guide for 2025 and Beyond

The healthcare industry is undergoing a seismic shift as it enters 2025, with technological advancements, regulatory updates, and evolving patient expectations reshaping the landscape. Organizations that anticipate and adapt to these changes will position themselves as leaders in delivering innovative, efficient, and patient-centered care. Here are five key areas where healthcare stakeholders must focus to… Continue reading Navigating the Future of Healthcare: A Strategic Guide for 2025 and Beyond