Today's Top 20 Stories
  1. North Carolina expanding Medicaid Dec. 1

    North Carolina will launch its Medicaid expansion program Dec. 1, which is expected to provide more than 600,000 state residents with coverage. 
  2. BCBS Oklahoma, Stillwater Medical Center strike agreement

    Blue Cross Blue Shield of Oklahoma and Stillwater (Okla.) Medical Center have reached an agreement that will keep Blue Traditional and Blue Choice PPO beneficiaries in network with the health system through 2026. 
  3. Kaiser Permanente names UnitedHealthcare exec as new health plan leader

    Oakland, Calif.-based Kaiser Permanente has named Brandon Cuevas as executive vice president for Kaiser Foundation Health Plan. 

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. 13 top execs that have recently left Optum

    In 2023, 13 top executives previously with UnitedHealth Group's Optum have announced retirement or new positions with companies across the country.
  2. 9 top execs that have recently left UnitedHealth Group

    From regional CEOs to its chief growth officer, these are nine top executives that have recently departed from UnitedHealth Group and its subsidiaries.
  3. Medicare Advantage in the headlines: 8 recent updates

    The National Committee for Quality Assurance has named the top Medicare Advantage plans of 2023, and new research is uncovering cost differences between MA and traditional Medicare. 
  4. The most popular TV shows for Medicare Advantage ads

    In 2022, viewers tuning into "Dr. Phil" saw an average of eight ads for Medicare Advantage plans per episode during open enrollment season, according to an analysis from KFF. 

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. Prime Therapeutics names chief compliance officer

    Prime Therapeutics has named Tizgel High as chief compliance officer. 
  2. Sendero Health Plans names CEO

    Sendero Health Plans has named Sharon Alvis as chief executive officer. 
  3. Elevance-BCBS Louisiana deal faces further delays

    Blue Cross and Blue Shield of Louisiana officials said they are again seeking to delay a regulatory hearing over its proposed sale to Elevance Health, reported Sept. 21. 
  4. How Blue Cross North Carolina is bucking rising costs in the ACA market, per its CFO

    Health insurers across the country are looking to raise premiums for individual exchange plans in 2024, with many proposing double-digit increases. In contrast, Blue Cross and Blue Shield of North Carolina says its members will see individual rates go down by an average of 4 percent next year.

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. Mississippi governor announces $690M Medicaid reforms for state's hospitals

    Hospitals and healthcare systems in Mississippi could benefit by approximately $690 million from a couple of planned proposals announced Sept. 21 by Gov. Tate Reeves.
  2. Kansas governor says Medicaid expansion the 'top priority' for 2024

    Kansas Gov. Laura Kelly has launched a statewide campaign pushing for Medicaid expansion, calling it her top priority for the state's legislative session next year.
  3. Bright Health's COO to leave company

    Bright Health's COO Jeff Cook is departing the company, effective Oct. 13.
  4. AHIP backs legislation expanding Medicare Advantage supplemental benefits

    Two lawmakers are introducing legislation that would expand the scope of supplemental benefits offered in Medicare Advantage. 
  5. Health insurers go all in on Mark Cuban's drug company

    It's been a busy year by any measure for Mark Cuban Cost Plus Drug Co., but especially within the world of health insurance.
  6. UnitedHealthcare cutting some Medicare Advantage plans, expanding overall footprint for 2024

    UnitedHealthcare is discontinuing some Medicare Advantage plans and exiting some service areas for 2024. 
  7. Why Medicare Advantage beneficiaries have lower healthcare utilization: 3 things to note

    Medicare Advantage beneficiaries have 12 percent lower healthcare expenses than beneficiaries in fee-for-service Medicare, a whitepaper from researchers at Inovalon and Boston-based Harvard Medical School found. 
  8. HHS pauses procedural Medicaid disenrollments in 30 states

    HHS has paused procedural Medicaid terminations in 30 states reporting issues with their automatic renewal systems, and coverage for nearly 500,000 people improperly disenrolled through the error will be restored, the agency said Sept. 21. 
  9. These payers air the most Medicare Advantage ads

    Humana and UnitedHealthcare account for nearly half of Medicare Advantage enrollment, but just 20 percent of television advertising for MA plans, according to a report from KFF published Sept. 20. 

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