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Centene is launching Custom Health Option and Individual Care Expense arrangements, recently rebranded from individual coverage health reimbursement arrangements, in…
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In a new lawsuit, Michigan Attorney General Dana Nessel is accusing Blue Cross Blue Shield of Michigan of conspiring with other Blues plans to block competition and using its grip on the health insurance market to overcharge the state and…
A Florida appellate court ruled Oct. 7 to expunge a grand jury report regarding a $10 million Centene donation to the Hope Florida Foundation, tied to Florida’s first lady, Casey DeSantis. Florida prosecutors launched a criminal investigation into the donation,…
Medicaid members with behavioral health conditions pass through emergency departments, inpatient units and outpatient follow-up as though each were a separate system. For most plans it is, and the members who need coordination most are the least likely to get…
Presented by:
- Kristi Carney, Director of Behavioral Health, CareSource, Indiana Market
- Nishi Rawat, MD, Chief Clinical Officer and GM Care Navigation, Bamboo Health
Harbor Health, an Austin, Texas-based company that operates medical clinics and offers health plans, plans to acquire 27 Village Medical primary care clinics in the Houston area. The deal is expected to close at the end of the year, according…
Health insurers are using AI to speed up prior authorization, but Fitch Ratings expects regulators to keep requiring humans in the loop when care is denied, and that will limit how much efficiency payers can gain. The outlook comes from…
Health insurers’ membership declined 2.8% year-over-year to about 312.5 million people in the first half of 2026, as losses in the individual market and Medicaid outpaced gains in Medicare Advantage and employer-based plans. The figures come from a Sept. 29…
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
Higher use of medical services and prescription drugs, rather than rising inflation-adjusted prices, drove a recent uptick in commercial spending at Blue Cross Blue Shield of Massachusetts, according to a study published Oct. 5 in Health Affairs. The analysis was…
Charlotte, N.C.-based Atrium Health launched a program to lower out-of-pocket costs for North Carolina State Health Plan members who use its physicians and hospitals, but State Treasurer Brad Briner warned the program could bankrupt the plan, North Carolina Health News…
As insurers pivot their market and product strategies, executive leadership has been evolving at health plans and their parent companies. Here are 29 health plan leadership moves to know from the second half of 2026:
Popular in Executive Moves
MLR Under Pressure: Where Risk Ends and Margin Begins
Presenters: Stewart Hinrichsen, Martin's PointRaj Lakhanpal, SpectraMedixSean Kelly, SpectraMedixCharles Chervitz, SpectraMedix
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