Rocket Doctor Expands in California with 2M+ New Members

We’re excited to announce Rocket Doctor is now in-network with another major New York insurer, extending access to 2.4 million members across the state. Eligible members across a broad range of care products, including individual and direct plans, can now access Rocket Doctor's network of board-certified physicians for medical, behavioral health, and ancillary services, all through our digital health platform. With this milestone, our total in-network reach now exceeds 15 million covered lives across key U.S. markets, reinforcing our continued payer network expansion and growing impact on healthcare accessibility. Read the full release: https://lnkd.in/e6GqKARZ

We’re pleased to share that Rocket Doctor has signed a new agreement with a major New York insurer, expanding access for approximately 20,000 additional Medicare Advantage and Dual-Eligible (D-SNP) members across the state. Effective April 1, 2026, eligible members will gain access to Rocket Doctor’s network of board-certified physicians through its digital health platform, delivering primary care, chronic disease management, preventive services, and coordinated follow-up care. With this agreement, Rocket Doctor’s in-network reach now exceeds 15 million covered lives across the United States, supporting our ongoing expansion of payer partnerships and broader access to physician-led care. Read more: https://lnkd.in/eAnZ34pY

Minnetonka-based Medica, which took over operations Jan. 1, says it has addressed long call center waits and delays with scheduling patient transportation.

Prior authorization shouldn’t delay patient care. Yet for many healthcare practices, it’s one of the biggest administrative burdens today. 📊 81% of medical groups say prior authorization requirements have increased since 2020. 📊 82% of requests can lead to treatment abandonment. Behind every approval request is time, paperwork, and pressure on already overloaded teams. In this blog, we break down the prior authorization process, the challenges physicians face, and how virtual support can help practices stay efficient without increasing overhead. 👉 Read the full blog to learn more: https://lnkd.in/g5jmjqF8 #HealthcareOperations #PriorAuthorization #PracticeManagement #HealthcareEfficiency #VirtualMedicalAssistants #PhoenixVirtualSolutions

What is A Single Case Agreement (SCA) For Out Of Network Providers? Sometimes medical and mental healthcare providers find themselves outside of [...] https://lnkd.in/e_jwHxrJ

While we continue to negotiate, Michigan Medicine has informed Blue Cross that it will terminate the in-network status of its southeast Michigan provider network of hospitals, outpatient facilities and physicians on July 1, 2026. This unilateral action puts patients in the middle of our negotiations. We’re working toward a fair deal that supports patients, safeguards employers, and ensures a more affordable, sustainable health care future for Michigan. Learn more: https://miblues.co/4bnwf73

Scripps stepping away from several Medicare Advantage contracts in 2024 did not surprise anyone working in provider contracting. Across the country, health systems and physician groups are reaching a breaking point with Medicare Advantage plans that combine high administrative burden, restrictive utilization controls, and reimbursement that often fails to reflect the true cost of care. At some point, providers have to ask a simple question: Is this contract sustainable for the organization and the patients we serve? What Scripps did is part of a broader shift. Health systems and medical groups are beginning to re-evaluate participation in plans that create operational strain without fair reimbursement or efficient collaboration. Medicare Advantage isn’t going anywhere. But the days of providers accepting unfavorable terms simply to stay “in network” are clearly coming to an end. The next phase of healthcare contracting will require real partnership between payers and providers one built on transparency, operational efficiency, and sustainable reimbursement. If that doesn’t happen, we should expect to see more systems follow the same roadmap! Physicians and patients shoukd be asking questions and holding payors accountable for being the bottleneck in physicians treatment patients.

Payers Made a Bold Prior Auth Commitment in 2025. Here’s What to Expect in 2026 - MedCity News 53 major insurers have pledged to streamline prior authorization by 2026. This included UnitedHealthcare, Aetna, Cigna, and most Blues plans. The commitments include: → Reducing PA requirements for certain claims → 90-day transition periods when patients change plans mid-treatment → Real-time responses for 80% of electronic PA approvals by 2027 As someone who works in access every day, I’ll believe it when I see it in practice. The intent is good, but the devil is always in the execution at the local payer level. What are you seeing in your territory? Any early signs of actual change?

Prior authorization is slowing down patient care and revenue. And the problem is getting worse. Here is what is actually driving the bottleneck in 2026. https://lnkd.in/gJEtjFPW #HealthcareRCM #PriorAuthorization #MedicalBilling

Many clinic owners assume being in-network always means better reimbursement. But that’s not necessarily true. In some cases, physical therapy clinics can collect more per visit out-of-network, depending on the payer and contract rates. The real question isn’t in-network vs out-of-network. It’s understanding how each affects: • reimbursement • patient responsibility • claim approvals • revenue cycle management I wrote a quick breakdown for clinics here: 👉 https://lnkd.in/gm37Pa_b Are most of your patients in-network or out-of-network?