Today's Top 20 Stories
  1. Gold Kidney Health Plan taps 2 UnitedHealth veterans

    Gold Kidney Health Plan has tapped two UnitedHealth veterans to assist with the company's national growth. 
  2. Mark Cuban's Cost Plus Drug Co. teams up with Intermountain's Select Health

    Salt Lake City-based Select Health, the non-profit insurance subsidiary of Intermountain Health, is partnering with Mark Cuban Cost Plus Drug Co. to bring lower cost medication offerings to its members. 
  3. How Medicare Advantage is being advertised on TV

    More than 85 percent of the nearly 650,000 Medicare TV ad airings over a nine-week stretch during the 2023 open enrollment period were for Medicare Advantage, according to a Sept. 20 report from KFF.

A new framework for measuring RCM success — Insights from Denver Health

RCM optimization isn't cheap — but what hospitals really can't afford is sticking to the status quo. Discover how this safety-net hospital is advancing digital transformation in RCM here.
  1. What's unique about the Medicare Advantage plans top-rated by members? 5 executives explain

    How do the top-rated plans for Medicare Advantage member satisfaction keep members happy? Simplifying healthcare, going above and beyond in customer service and offering strong basic benefits, executives told Becker's. 
  2. 5 ways Medicare Advantage and traditional Medicare differ on affordability: Survey

    Around 1 in 5 adults with Medicare reported high healthcare costs in the last year, qualifying them as underinsured, according to a survey from the Commonwealth Fund. 
  3. HCA hospitals in Tennessee, Kentucky could split with Cigna Oct. 1

    HCA hospitals in Tennessee and Kentucky will go out of network with Cigna Healthcare if a new contract is not in place by Oct. 1.
  4. Digital health coverage 'not yet fully realized' across commercial payers: AMA study

    There's a lack of commercial coverage for digital healthcare services compared to publicly-funded health plans, which is limiting access to care for more than half of the U.S. population, according to new research published by the AMA on Sept. 19.

5 signs it's time for end-to-end RCM

There are 5 signs that it's time to switch to end-to-end RCM. Learn what they are + solutions here.
  1. Some health plans slow to cover new COVID booster

    Updated COVID-19 boosters have started rolling out to pharmacies nationwide, but some individuals are reporting a high price tag associated with getting a shot.
  2. CarelonRx to launch integrated generic drug cost savings program

    Elevance Health's pharmacy benefit manager, CarelonRx, is launching a new integrated cost savings program to automatically offer members the lowest price for generic prescription drugs while at their preferred pharmacy.
  3. Bright Health owes CMS $380M in risk adjustment payments

    Bright Health owes CMS $380 million in risk adjustment payments from its shuttered insurance business, the company said Sept. 19. 
  4. Medicare Advantage beneficiaries with Alzheimer's disease more likely to switch to traditional Medicare: Study

    Medicare Advantage beneficiaries with Alzheimer's disease and related dementia are 1.4 times more likely to switch to traditional Medicare than their counterparts without the disease, a study published Sept. 15 in JAMA Health Forum found. 

How one Midwest hospital is driving financial efficiency with interconnected systems

Major time savers can stem from single logins. That's how 1 hospital achieved a 50% reduction in month-end close time — read the short case study, here.
  1. Magellan Health taps two market leaders

    Magellan Health, a subsidiary of Centene, has named Arthur Hennig as senior vice president and chief business officer for payer markets and Sara Pierce as senior vice president and chief business officer for the employer market.
  2. 9 top execs that have recently left Elevance Health

    From the CFO of its government business division to the COO of Carelon, these are nine executive departures from Elevance Health and its subsidiaries over the last year:
  3. Ex-Cigna employee agrees to pay $33K to settle insider trading allegations

    Former Cigna employee Jonathan Ferrie will pay more than $33,000 to settle insider trading allegations from the U.S. Securities and Exchange Commission. 
  4. HHS finalizes rule to streamline enrollment in Medicare Savings plans

    Greater access to care and making such care more affordable may be on the horizon for lower-income older adults and people with disabilities after the Department of Health and Human Services and CMS finalized a rule to streamline enrollment in the Medicare Savings Programs. The move was described in a Sept. 18 news release as the most significant HHS action in a decade for such care.
  5. Aetna to enter Maryland ACA exchange 

    Aetna has filed to offer individual health plans on the Maryland ACA exchange in 2024.
  6. 11 payers cutting jobs

    Payers are trimming their workforces or jobs due to financial or operational challenges, along with restructuring stategies. 
  7. AmeriHealth Caritas names Florida market president

    AmeriHealth Caritas has named Melody Bonomo as Florida market president. 
  8. The fate of North Carolina's Medicaid expansion could be tied to casinos

    North Carolina lawmakers are proposing tying funding to expand the state's Medicaid program to a bill approving four new casinos in the state, the News and Observer reported Sept. 18. 
  9. Oregon to establish basic health program for lower income adults

    Oregon is asking CMS to approve a basic health program for lower-income individuals who make too much to qualify for Medicaid, a move that could raise premiums prices on the state's individual insurance market. 

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