The bottleneck in AI-enabled real-world data analysis is not computation, model architecture, or training data volume. It is the semantic layer over which the AI is trying to reason – the place where precise clinical meaning lives. The post Better Models Won’t Fix Pharma’s AI Problem — Better Terminology Will appeared first on MedCity News.

When payors consider only the cost of the medication and not the cost and risk to the patient, doctor, and healthcare system, the irony is that not only is this terrible for patient health, it can be more costly in the end. The post The True Cost of Focusing on Cost Instead of Cost-Effectiveness appeared first on MedCity News.

PatientRightsAdvocate.org sued the American Medical Association this week, arguing the trade group has no valid copyright over the CPT codes that providers must use to bill for care. It follows a public letter Senator Bill Cassidy sent to the AMA last year accusing it of “abus[ing] [its] government-backed monopoly by charging exorbitant fees to anyone using the CPT code set.” The post Patient Group Sues AMA, Says the Org Shouldn’t Be Charging for CPT Codes appeared first on MedCity News.

Venrock led Aligned Marketplace’s Series A round. In total, the company has raised $31 million to date. The post Aligned Marketplace Secures $20M for Advanced Primary Care Marketplace appeared first on MedCity News.

Bristol Myers Squibb’s Zenbexus is the first FDA-approved drug in a new class of cancer drugs called CELMoDs. The pharma company is positioning this molecule as a successor to its legacy products for multiple myeloma. The post Bristol Myers Squibb Protein Degrader Wins First-in-Class FDA Nod in Multiple Myeloma appeared first on MedCity News.

Most younger professionals entering the workforce have little visibility into interoperability, digital health infrastructure, or healthcare data architecture as career pathways.  The post Healthcare Keeps Buying AI. But Nobody’s Building the Workforce to Run It. appeared first on MedCity News.

A court ruling struck down key parts of how regulators calculate the No Surprises Act’s qualifying payment amount, siding with the Texas Medical Association’s argument that the formula has historically favored payers in arbitration. The post Appeals Court Sides with Providers in No Surprises Act Pay Dispute appeared first on MedCity News.

Cotiviti launched an AI-powered coordination of benefits solution that uses enrollment data to identify and resolve coverage issues before claims are submitted. The post Cotiviti Launches AI Solution to Address Coordination of Benefits Issues appeared first on MedCity News.

Sangamo Therapeutics filed for Chapter 11 bankruptcy in June after its search for strategic alternatives failed to find a path forward for the company. PTC Therapeutics’ auction win brings a Sangamo gene therapy candidate for Fabry disease, a rare inherited disorder with few treatment options. The post PTC Therapeutics’ $211M Bid Wins Bankruptcy Auction for Sangamo Gene Therapy appeared first on MedCity News.

In healthcare, enterprises are moving slower than the hype cycle would lead you to believe. That said, they’re not moving slowly – they are saying yes to AI, as long as it can solve for specific workflow needs. The post Founders Should Stop Worrying If They’re “AI Enough” appeared first on MedCity News.

The 1842 Fund launched a new startup called Suvi Health, which is developing an ambient AI platform that records hospital bedside conversations and turns them into a shared task list for patients and families. The company will pilot the tool with Mayo Clinic starting next month. The post New Startup Launches to Close the Bedside Communication Gap in Hospitals appeared first on MedCity News.

A new survey finds that employers are moving away from the Big Three PBMs while prioritizing healthcare affordability and transparency. The post Report: Employers’ Use of Big Three PBMs Falls in 2026 appeared first on MedCity News.

Deerfield Management formed Boulevard Bio with scientific co-founders Georg Schett and Frank Nestle. The startup’s lead program is in early clinical development for an autoimmune kidney disorder, and could offer dosing advantages over a recently approved Vera Therapeutics medicine and a Vertex Pharmaceuticals drug currently under FDA review. The post Startup Boulevard Bio Launches With Immune Reset Pioneer Schett as Co-Founder appeared first on MedCity News.

While organizations have invested heavily in expanding ambulatory networks, many are discovering that operational workflows have not evolved at the same pace. The result is a growing gap between demand and the systems designed to manage it. The post Ambulatory Growth Demands a New Operating Model appeared first on MedCity News.

Revenue cycle vendor Unlimited Technology Systems disclosed a ransomware attack affecting 3.8 million patients — the second-largest healthcare data breach reported to HHS this year. The post Health IT Vendor’s Data Breach Exposes Nearly 4M Patient Records appeared first on MedCity News.