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Cigna is facing a lawsuit claiming it made a profit by underpaying out-of-network ground ambulances, according to a class-action complaint…
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Enrollment in the individual market fell 18% between June 2025 and June 2026, a drop of more than 4.6 million people, according to an Oct. 14 KFF analysis. Looking at comparable periods in previous years, enrollment has generally increased, growing…
Arbitration awards under the No Surprises Act can reach nearly 6% of total commercial medical spend in some regions, UnitedHealthcare CEO Tim Noel said during an Oct. 13 earnings call. The medical cost trend for UnitedHealthcare’s commercial business is “exceeding”…
Molecular residual disease (MRD) testing is moving into the next phase of precision oncology, extending molecular insight past diagnosis and treatment selection into post-treatment monitoring, surveillance and survivorship. For health systems, the question is not whether to add another test.…
Presented by:
- Rick Baehner, MD, Chief Medical Officer, Precision Oncology Abbott Cancer Diagnostics, Clinical Professor of Pathology,, University of California, San Francisco
The American Hospital Association is challenging a Blue Cross Blue Shield Association analysis that estimated rising hospital coding intensity added $942 million in costs and linked the trend to AI-enabled billing tools. The AHA argued in an Oct. 5 blog…
Maryland regulators are studying whether nonprofit hospitals’ offshore captive insurance companies, subsidiaries that hospitals form to cover their own risks such as malpractice claims, should be subject to the state’s 3% premium tax. The Maryland Insurance Administration held a public…
Recent research has indicated Americans are warming up to “Medicare for All” propositions ahead of the 2026 midterm elections. The latest Axios/Ipsos American Health Index survey polled 1,122 adults in late September. It found that 43% of Americans would support…
Value-based care promised better outcomes at lower cost. Years of effort and millions in infrastructure later, payer leaders are asking a blunt question: is it delivering? On Oct. 21, join us for a candid discussion built for payer leaders that…
Presented by:
- Tim Smith, ASA, MAAA, MS, Chief Actuary, Arbital Health
- Niall Brennan, Chief Data and Analytics Officer, Horizon BCBS
- Ali Khan, MD, MPP, FACP, Advisor, Andreessen Horowitz, Former CMO of Medicare, Aetna
Health plans covered by a federal interoperability rule must begin processing prior authorization requests electronically Jan. 1, but the rule’s reach into ASCs may be limited. It excludes many of the payers ASCs depend on most, and the systems that…
Roughly 1.1 million Medicare beneficiaries have signed up to access discounted GLP-1s through CMS’ Bridge model, HHS Chief Counselor Chris Klomp said during an Oct. 7 Wall Street Journal event. The pilot launched July 1, rolling out to Medicare Part…
Blue Cross and Blue Shield of Louisiana has named Brian Keller president and CEO, effective Dec. 1. Mr. Keller will succeed Bryan Camerlinck, who announced his planned retirement earlier this year. Mr. Camerlinck will remain president and CEO through Nov.…
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