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CMS says its “Medicaid Fraud War Room” has identified 50 high-risk providers tied to more than $203 million in Medicaid…
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Medicare Advantage will account for 57% of overall Medicare enrollment by 2036, up from 51% this year, according to a July report from the Congressional Budget Office. Five things to know:
Federal subsidies for employment-based health coverage will grow to $840 billion in 2036, up from $478 billion in 2026, according to a July report from the Congressional Budget Office. Five things to know:
This webinar is on-demand and can be viewed at your convenience. At many infusion centers, nurse schedules are built on tradition rather than data, leaving teams stretched thin on busy days and overstaffed on slow ones. As patient volumes rise…
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Presented by:
- Amanda Carbray, Clinic Operations Manager, Hartford HealthCare
- Betsy Hlavac, Clinical Operations Manager, Ambulatory Infusion & Medical Oncology, Hartford HealthCare
More data is pointing to concerns of skyrocketing healthcare costs in the upcoming years. Steeper medical utilization is one cause for concern, according to several sources. Meanwhile, HR 1 is radically reshaping Medicaid, and the expiration of ACA enhanced subsidies…
Utilization review teams face a constant squeeze: manual EHR searches for clinical documentation slow admission and appeal processes, introduce errors and raise denial risk — all while revenue hangs in the balance. Stormont Vail Health confronted these inefficiencies directly. By…
On Demand
Presented by:
- Chad Yeager, RN, MSN, VP of Quality and Population Health, Stormont Vail Health
- Brianna Brown, MSN, BSN, RN-BC, CCDS, Director of Clinical Performance, Stormont Vail Health
- Sri V. Suravarapu, MD, MPH, CPE, CHCQM-PHYADV, Medical Director of Utilization Review / Clinical Appeals, Stormont Vail Health
Despite time-outs and standard protocols, positioning-related nerve and pressure injuries continue to occur in spine surgery. They tend to strike where teams least expect them — in high-complexity cases, in prone and lateral positions, and in patients whose risk was…
Presented by:
- Jen Anzalone MSN, RN, CNOR, CSSL, NPD-BC, NE-BC, Perioperative Consultant and Surgical Services Nurse Manager, J. Anzalone Consulting
Excellus BlueCross BlueShield must face claims of race discrimination and retaliation brought by a former contract negotiation director, according to a July 22 federal court order. U.S. District Court Judge Anthony Brindisi denied Excellus’ motion for summary judgment and allowed…
Oregon regulators have released ATRIO Health Plans from state supervision three months after finding the Medicare Advantage insurer was in a “hazardous financial condition.” The Oregon Division of Financial Regulation terminated the supervision July 14, saying the conditions that prompted…
Jefferson Health is alleging Independence Blue Cross used a string of reimbursement policy changes this year to cut what it pays the health system by an amount approaching $100 million in a new lawsuit. The July 22 complaint, filed in…
HHS and CMS appealed a Maryland federal court’s decision to vacate parts of CMS’ 2025 “Marketplace Integrity and Affordability Rule,” according to July court filings. In the case — which has the city governments of Columbus (Ohio), Baltimore and Chicago, as well as…
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