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Faster Prior Authorization Will Not Help Labs If the Evidence Is Still Missing
Washington is finally speeding up prior authorization. For laboratories, faster will not be enough. Federal rules that took effect in January require the major government-program payers to answer prior authorization requests within days rather than weeks. A proposed rule published in April would extend the same machinery to drugs while asking, for the first time, […]
xPress
Interoperability’s Next Job Is Adjudication
Pay for performance is the most agreed-upon idea in American healthcare and one of the least achieved. Payers endorse it. Drugmakers keep proposing warranties tied to it. And yet after a decade of concerted national effort, 28.7 percent of healthcare payments carried downside risk in 2024, barely up from 28.5 percent the year before. The […]
xPress
The New Currency of Healthcare Data Is the Treatment Relationship
The most valuable thing in healthcare right now is not a data connection. It is a treatment relationship. For two decades, access to health data was determined by relationships and private contracts between institutions. If you wanted records, you negotiated for them. You signed an agreement with a hospital, a lab, or a health system, […]
xPress
Interoperability Is Not Intelligence
Interoperability Is Not Intelligence Healthcare has spent much of the past decade treating health data interoperability as a proxy for progress. For years, the system was defined by disconnected records, institutional silos, and basic failures of access. Before data could become useful, it first had to become available, and the industry had to solve the […]
xPress
Quiet Part Out Loud
The market has finally caught up. As copycat and cloned companies flood the space with nearly identical messaging, one thing has become clear: retrieving medical records at scale is no longer a differentiator. Copy-paste marketing has turned access into a commodity. And that is fine, because access was never the hard part now that we […]
xPress
HIE Networks vs. the Power of TEFCA
How We Shift the Technology Burden Away from Health Systems For more than a decade, Health Information Exchanges (HIEs) have played a central role in connecting providers, hospitals, and public health agencies across regions and states. They emerged at a time when health data interoperability was fragmented, standards were inconsistent, and healthcare organizations largely carried […]