A prediction for 2025 from Laura Kohlhagen, M.D., MBA, chief medical officer, of Altera Digital Health.
Looking toward 2025, we will see improved care coordination and member engagement as more payers align to trust frameworks and standards like Trusted Exchange Framework and Common Agreement [TEFCA] and Fast Healthcare Interoperability Resources [FHIR].
Kohlhagen
Additionally, more healthcare organizations will leverage AI [artificial intelligence] to identify at-risk patients and proactively provide recommendations for treatment and aid based on social determinants of health. Healthcare organizations placing greater emphasis on health equity will expand initiatives like vaccination campaigns and preventive care programs to better meet the needs of high-risk populations.
Finally, as AI expands across the industry, we will also see increased adoption of AI in claims processing and fraud detection to reduce manual intervention and errors.
Sarepta Announces Positive Results for Elevidys, Gene Therapy for Duchenne
February 12th 2025Results show improved functional outcomes for people with Duchenne muscular dystrophy who are ambulatory. Elevidys, which is priced at $3.2 million per dose, produced $821 million in net product revenue for the company in 2024.
Read More
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
Updated: CVS Health’s Medical Benefit Ratio Increases But Company Sees Better Path for 2025
February 12th 2025CVS Health’s healthcare benefits segment, which includes Aetna, had medical benefit ratio of 92.5% in 2024, because of higher utilization, an unfavorable impact of Medicare Advantage star ratings payment and higher levels of care in Medicaid.
Read More
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen