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Individual coverage health reimbursement arrangements, recently rebranded to CHOICE, could boost individual ACA enrollment by up to 7.6% in some…
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Elevance Health has named Mike Jones president of its Florida operations. Mr. Jones will oversee the company’s Medicaid and Medicare businesses in the state, including Simply Healthcare Plans, Clear Health Alliance, Freedom Health, Optimum HealthCare and HealthSun, according to a…
Texas state Rep. John Bucy III, D-Austin, prefiled two bills Nov. 9 for the 2027 legislative session that focus on expanding Medicaid in the state. HB 101 and HB 102 would extend medical assistance to all applicants for whom federal…
Patient access is often the first place health systems apply artificial intelligence. Scheduling, confirmations, cancellations and reschedules are high-volume, rules-heavy and chronically understaffed which is why voice agents and other automation tend to land here first. But the gap between…
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St. Louis-based Ascension will close an insurance unit and lay off 51 workers as it moves administration of its employee health plan to an outside company, the St. Louis Post-Dispatch reported Nov. 7. The unit, Ascension Care Management Insurance Holdings…
Mike Yetter is joining WellSense Health Plan, under Boston Medical Center Health System, as CIO, according to a Nov. 9 LinkedIn post. Mr. Yetter most recently worked at Jefferson Health Plans, part of Philadelphia-based Jefferson Health. Mr. Yetter’s LinkedIn profile…
Oakland, Calif.-based Kaiser Permanente recorded an operating income of $495 million (1.4% operating margin) in the third quarter of 2026, up from $218 million (0.7% margin) during the same period last year, according to its Nov. 6 financial report. Seven…
Health systems deliver complex care every day. Far less of it reaches the final bill intact. Between the bedside and the claim sits a patchwork of quality teams, coders, retrospective reviews and post-discharge vendors, all working to reconstruct decisions already…
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CMS is ending its Medicare Part D Premium Stabilization Demonstration at the end of 2026, bringing standalone drug coverage back to “traditional market conditions,” per the agency. After the Inflation Reduction Act redesigned Part D to lower drug cost-sharing, Part…
Health systems across the country are making very different bets on whether to be in the insurance business. Carle Health, Michigan Medicine, Memorial Hermann, Providence, and UMass Memorial have all shuttered or sold their insurance arms within the last two…
The attorneys general of Oregon, Minnesota, New Mexico and Washington are suing HHS and CMS, arguing the federal government cannot pull existing Medicaid funding from states that don’t adopt the Medicaid work requirement in HR 1. The lawsuit, filed Nov.…
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