Morning Briefing
Summaries of health policy coverage from major news organizations
Epic's Real-Time Prior Authorization Checks Now Used By 4 Health Systems
Four health systems are now using real-time prior authorization checks embedded in the Epic electronic health record, tackling a major pain point for providers. The electronic health record giant collaborated with insurers UnitedHealthcare, Network Health and Aetna to set up the electronic workflows to modernize the manual and time-consuming prior auth process. (Landi, 8/17)
More healthcare industry developments —
After a bruising few years, Medicare Advantage has emerged as the healthiest business line for some big insurance companies. Major Medicare Advantage insurers that reported second-quarter earnings in recent weeks indicated their march back to profitability is miles ahead of expectations. Nearly all of them — UnitedHealth Group, CVS Health, Elevance Health, Molina Healthcare and Centene — raised their annual earnings guidance to account for lower-than-anticipated Medicare Advantage spending. (Tepper, 8/18)
Alignment Health has filed a motion to dismiss a former executive’s whistleblower lawsuit accusing the insurance company of allegedly engaging in accounting fraud. The complaint, filed in July, claimed the Medicare Advantage carrier allegedly forced plaintiff Hakan Kardes to resign after he reported the alleged financial irregularities. (Tepper, 8/18)
Nearly every U.S. hospital screens patients for sepsis, but far fewer have dedicated personnel to ensure screening is successful, the CDC found. Moreover, separate research links a lack of specific accountability to higher mortality. In its latest annual survey of hospital sepsis programs, covering 2025, the CDC found that 93% of 5,430 hospitals have a standard process to screen for sepsis and 87% use order sets tailored to their patients. But only 36% employ a sepsis coordinator to oversee day-to-day operations, and 32% have support from staff with expertise in data, analytics and information technology. (Twenter, 8/18)
Hospitals in abortion ban states quickly developed standards to protect clinicians from legal risks when providing abortions in cases where the health or life of the mother is at risk, a qualitative study showed. (Robertson, 8/18)
AI in healthcare —
Revenue cycle management company R1 has agreed to acquire Humata Health. The deal is on track to close in the third quarter, according to a Tuesday news release. Financial details were not disclosed. (Hudson, 8/18)
The American Medical Association is out with a new framework for physicians' role in the age of AI, provided first to Axios, that insists doctors remain central to patient care. Why it matters: The debate over whether AI will supplant doctors in clinical care is heating up, but the AMA has remained adamant that humans not only must remain in the loop but can't be replaced. (Owens, 8/19)
Hippocratic AI CEO and co-founder Munjal Shah believes the company has found the sweet spot for healthcare artificial intelligence: non-diagnostic clinical work, such as chronic disease management. That focus serves as safeguard for Hippocratic AI, which develops AI voice agents for healthcare organizations, Shah said. (Famakinwa, 8/18)
Laura Reiley knew that her only daughter, 29-year-old Sophie Rottenberg, was struggling. It was the fall of 2024, and Rottenberg was at the end of a short career break. "She was complaining of sleep disruption and anxiety," says Reiley, who lives in Ithaca, New York, with her husband. (Chatterjee, 8/18)
