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The Blue Cross Blue Shield Association submitted a wide-ranging letter to CMS on March 30 in response to the agency’s…
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Carolina Complete Health and WellCare of North Carolina, both Centene Corp. subsidiaries, secured regulatory approval to move forward with their merger to form a managed care organization, according to an April 2 news release from the parent company. The entity…
Women keep your hospital moving. An MSK plan designed around women’s health can keep them physically, mentally and emotionally engaged while keeping your hospital healthy. Download this e-book to uncover insights about the women at your health system. You’ll learn…
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Healthcare has spent the last decade digitizing clinical and financial workflows. Transportation is one of the last major functions still operating without true infrastructure—and it is costing health plans more than they realize. Non-emergency medical transportation (NEMT) exists to solve…
Clinical Documentation Integrity (CDI) teams play a critical role in ensuring diagnoses are accurate, supported, and reflective of the care delivered. But as charts grow more complex and payer scrutiny of retrospective documentation review increases, changes to documentation that happen…
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Dr. David Kirk, MD
Chief Medical Officer, Regard
Fran Jurcak MSN, RN, CCDS, CCDS-O
Independent Consultant – CDI and Revenue Cycle
Pharmacy procurement becomes increasingly difficult to manage as health systems expand. Many organizations have centralized strategies in place, yet purchasing decisions remain reactive. The result: inconsistency, missed savings and increased compliance risk across the enterprise. This session explores where traditional…
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Presenters
Jessica Daley
Consultant, Pharma Logistics
Calvin Hunsicker
Founder and Chief Product Officer, SureCost
Chad O’Connor
VP/GM Acute, SureCost
CMS awarded its Medicare Advantage independent review entity contract to C2C Innovative Solutions, according to a March 31 CMS letter published by the AMA. C2C secured the contract Feb. 26. Effective May 1, C2C will review appeals of adverse reconsiderations,…
Blue Cross Blue Shield of Minnesota posted a $353 million operating loss in 2025, driven largely by losses in its Medicare Advantage and Medicaid businesses, the insurer said April 1. The plan paid $9.8 billion in medical and pharmacy claims…
A federal judge has dismissed a class action lawsuit that accused UnitedHealthcare of illegally installing third-party tracking software on its website to collect visitor data without consent. The case, originally filed in October 2025, was brought by a California resident…
Houston-based Memorial Hermann Health System’s contract with BCBS Texas expired April 1, rendering the health system out of network. Commercial and ACA exchange (both individual and family) plan members lost access at the end of March. Memorial Hermann has been…
Interoperability has long been healthcare’s unfinished project. Despite decades of investment, the industry still operates within fragmented data environments that struggle to keep pace with care delivered across hospitals, physician groups, labs, post-acute providers and community settings. As care delivery…
Presenters
Amy Roberts
Director of Health Information Systems and Information Technology, Raleigh Neurology Associates
Sam Lambson
Vice President of Product Management, Platform, athenahealth
Lauren M. Smith MD, MBA
Chief Medical Officer Cook County Health
Nilesh Desai, MBA, BS, RPh, CPPS, CPEL
Chief Pharmacy Officer University of Miami Health System
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