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The national uninsured rate held steady at 7.9% in 2025, with 26.7 million people having no health coverage, according to…
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Your technology is live—but can you demonstrate what improved? Before making the next investment, health system leaders need to understand what existing capabilities are delivering, what the data tells them about performance, and whether remaining gaps involve technology, workflow, ownership,…
Presented by:
- Chae Menard, VP Professional and Advisory, Claritev
- Stephanie Farley, Dir. Solutions & Consulting, Claritev
Provider organizations have the budget, the roadmap and the confidence. Scaling is still where initiatives break down. Digital transformation spending is climbing across the industry, and 92% of executives expect measurable ROI within 24 months. But asked to name the…
Health plans are getting squeezed from several directions at once. Administrative costs press against the medical loss ratio ceiling, new prior authorization rules set binding turnaround times and require public denial reporting, and members and providers expect answers in minutes.…
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Dispute activity under the No Surprises Act continues to evolve, court decisions are influencing the regulatory landscape, and the Final Rule could change how health plans and healthcare organizations approach key requirements. This session offers a data-driven look at where…
Presented by:
- Jennifer Forcash, Assistant Vice President Surprise Bill Solutions, Claritev
The National Committee for Quality Assurance has named the highest quality and most effective health plans of 2026 based on clinical quality, patient experience and health plan accreditation status. The ratings were released Sept. 16 and are based on 2025…
SCAN Health Plan has emerged as a major Medicare Advantage partner for retailers, with Walmart now partaking in a co-branded plan. The health insurer and retailer are launching the plan in two states, according to a Sept. 16 SCAN news…
Healthcare navigation company Quantum Health named Susan Mani, MD, chief medical officer. Dr. Mani joins the company from Humana where she served as AVP of clinical strategy and operations. She previously served as AVP of population health strategy for the…
Health system leaders face relentless pressure to deliver capital cost savings, eliminate equipment redundancy, and repeatedly defend replacement cycles. Yet they must often confront these challenges with incomplete data, siloed systems, and aging spreadsheet-based workflows. The result: purchasing decisions driven…
Presented by:
- Kelley Jacobsen, Senior Vice President, Supply Chain & Shared Services, Trimedx
- David Stevens, Vice President & GM, Clinical Asset Management, Trimedx
Humana and UnitedHealthcare received a combined total of $177.8 million in Medicare Advantage overpayments tied to coding that was not supported by medical records, the HHS Office of Inspector General said in separate audit reports published Sept. 15. The OIG’s…
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Adventist HealthCare, based in Gaithersburg, Md., seeks a vice president of revenue cycle…
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How Tufts Medicine connects behavioral health patients to care — before they’re lost.
Presenters: Jenny Chiang, MD, Tufts Medicine Integrated NetworkNishi Rawat, MD, Bamboo Health
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