Today's Top 20 Stories
  1. OIG: Trinity's Medicare Advantage plan received estimated $3.7M in overpayments

    MediGold, the Medicare Advantage subsidiary of Livonia, Mich.-based Trinity Health, received an estimated $3.7 million in net Medicare Advantage overpayments in 2017 and 2018, according to an audit from HHS' Office of Inspector General published Feb. 16. 
  2. What's behind Aetna's industry-leading Medicare Advantage growth?

    It's no secret that big insurers are facing challenges in the Medicare Advantage space, leaving enrollment growth flat or even on the decline for much of the industry in 2024.
  3. BCBS Massachusetts names chief people officer

    Blue Cross Blue Shield of Massachusetts has named Simmi Singh as chief people officer and executive vice president.

The state of AI in healthcare

86% of healthcare leaders say AI will define success over the next 5 years. Insights + strategies for successful adoption here.
  1. Friday Health collapse spurs consumer protection bill in Colorado

    Colorado lawmakers are considering a bill that would prevent customers from incurring extra out-of-pocket costs if their insurer goes bankrupt in the middle of the year. 
  2. Medicaid programs embrace doula care

    Thirteen states provide doula coverage through their Medicaid programs, and another 12 are in the process of implementing coverage, according to a report from the Elevance Health Public Policy Institute. 
  3. Mississippi lawmakers push Medicaid expansion bill with work requirements

    Mississippi lawmakers have introduced a bill that would expand Medicaid for an estimated 250,000 residents, ABC affiliate WAPT reported Feb. 19. 
  4. Payers urge 'stability' from CMS on Medicare Advantage

    CMS needs to do more to account for rising utilization rates in Medicare Advantage, the Better Medicare Alliance argued. 

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. 3 Medicaid redetermination updates

    Nearly 17 million people have been disenrolled from Medicaid since April 2023. 
  2. Medicare Advantage enrollees receive less postacute care: Study

    Medicare Advantage enrollees received less intensive postacute care than their counterparts in traditional Medicare, but did not have a significant change in short-term outcomes, a study published Feb. 16 in JAMA Health Forum found. 
  3. Blue Cross Blue Shield in the headlines: 5 updates

    From canceled acquisitions to contract challenges in court, these are five key updates about Blue Cross Blue Shield companies reported by Becker's in 2024:
  4. Top challenges, opportunities facing insurance industry in 2024, per 350 execs

    Technology modernization and the alignment of investments with organizational goals, along with picking the right vendor to partner with, are top of mind for payer executives in 2024, according to a Jan. 30 survey published by digital solutions firm HealthEdge.

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. As workers stay remote, insurers are leaving headquarters behind

    With fewer employees spending five days a week in-office, two of the nation's largest insurers are consolidating their headquarters. 
  2. Nebraska lawmakers mull Medicaid coverage of weight loss drugs

    Nebraska lawmakers are considering requiring the state's Medicaid program to cover GLP-1 drugs, the Omaha World-Herald reported Feb. 15. 
  3. UnitedHealthcare names chief operating officer

    UnitedHealthcare has named Michael Baker as chief operating officer. 
  4. 'One of the challenges is ubiquity': How CareFirst's CEO is driving local healthcare on the national stage

    Brian Pieninck has led CareFirst BlueCross BlueShield as president and CEO for nearly six years, and he was recently elected as chair of the Blue Cross and Blue Shield Association's board of directors.
  5. Medicare Advantage in the headlines: 10 recent updates

    It has been a busy few weeks for Medicare Advantage policy. CMS proposed a slight cut in benchmark rates, and payer executives were split on the impact of rising costs in the business. 
  6. Some health systems ditch their health plans

    Some health systems are getting out of the insurance business. 
  7. Payers ranked by Medicaid losses in 2023

    Medicaid redeterminations began in April 2023, and all major payers have released their 2023 earnings, revealing which recorded the largest enrollment losses in the Medicaid market.
  8. Cigna to buy back $3.2B in stock

    The Cigna Group is buying back $3.2 billion in common stock through accelerated repurchase agreements with Deutsche Bank and Bank of America, the company announced Feb. 15. 
  9. Cigna names Midwest general manager

    Cigna Healthcare has named Lisa Buckley general manager for its Midwest group employer business. 

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