Today's Top 20 Stories

  1. Humana payment rates for diabetes with complications

    Andrew Cass -
    Humana PPO payment rates for diabetes with complications ranged from $31,998 for Houston-based Memorial Hermann to $6,376 for Johnson City, Tenn.-based Ballad Health, according to data compiled by Hospital Pricing Specialists.

  2. Optum to move out of 54-acre Minnesota campus by year's end

    Rylee Wilson -
    Optum will move out of an Eden Prairie, Minn.-based campus with 473,000 square feet of office space by the end of 2023, the Minneapolis/St. Paul Business Journal reported Nov. 2. 

  3. Medicaid disenrollments top 10 million

    Rylee Wilson -
    More than 10 million people have been disenrolled from Medicaid since continuous coverage requirements ended in April, according to KFF. 

The state of AI in healthcare

Sponsored
86% of healthcare leaders say AI will define success over the next 5 years. Insights + strategies for successful adoption here.

  1. Cigna taps dental and vision VP

    Andrew Cass -
    Cigna has named Manish Naik vice president of the company's dental and vision businesses. 

  2. Kamala Harris spotlights AI's potential harm in health insurance

    Andrew Cass -
    Vice President Kamala Harris said that while artificial intelligence has the potential to do profound good, it also has the potential to cause profound harm, and that potential for harm includes actions by health insurance companies. 

  3. Cigna posts $1.4B profit in Q3

    Jakob Emerson -
    The Cigna Group raised its year-end revenue projections to $192 billion, according to the company's third quarter earnings published Nov 2.

  4. UnitedHealth violated labor laws during layoffs, former employees allege in lawsuit

    Jakob Emerson -
    UnitedHealth Group and Optum violated state and federal employee notification laws during mass layoffs that occurred earlier this year, two former employees allege in a lawsuit filed Oct. 30 in a California federal court. 

How one Midwest hospital is driving financial efficiency with interconnected systems

Sponsored
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. Medica names CEO

    Rylee Wilson -
    Medica has named Lisa Erickson as its next president and CEO. 

  2. Humana: COVID-19 hospitalizations driving higher Medicare Advantage costs

    Rylee Wilson -
    An increase in COVID-19 inpatient admissions is one factor driving higher utilization rates in Medicare Advantage, Humana executives said. 

  3. Centene partners with Walmart

    Jakob Emerson -
    With open enrollment underway, Centene's Ambetter from Sunshine Health, the payer's ACA subsidiary in Florida, is adding Walmart Health centers to its preferred provider network.

  4. Humana posts $832M profit in Q3

    Rylee Wilson -
    Humana reported a 30% decline in net income year over year in the third quarter of 2023. 

How one Midwest hospital is driving financial efficiency with interconnected systems

Sponsored
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. UnitedHealthcare's 2nd wave of prior authorization cuts begins

    Andrew Cass -
    The second and final wave of UnitedHealthcare's prior authorization cuts began Nov. 1. 

  2. UnitedHealthcare's total employees by state

    Jakob Emerson -
    UnitedHealthcare's employee count ranges from 32,000 in Texas to under 100 in Alaska, according to the company's website.

  3. UnitedHealthcare's total membership by state

    Jakob Emerson -
    UnitedHealthcare has the most members in Texas, according to the company's website.

  4. Aetna in the headlines: 8 recent updates

    Rylee Wilson -
    CVS Health is planning to lay off more employees at insurance subsidiary Aetna, and the company improved its Medicare Advantage ratings for 2024. 

  5. Value-based care growth stagnant in 2022

    Rylee Wilson -
    Value-based care models did not grow from 2021 to 2022, though more dollars moved to two-sided risk-based models, according to the Healthcare Payment Learning and Action Network's annual report published Oct. 30. 

  6. What's new for ACA open enrollment: 5 notes

    Rylee Wilson -
    Open enrollment for individual plans on the ACA exchange runs from Nov. 1 to Jan. 15.  

  7. UnitedHealth closes acquisition of UK company

    Andrew Cass -
    UnitedHealth Group has completed its acquisition of health technology firm EMIS Group, according to an Oct. 27 EMIS Group news release. 

  8. OIG: Humana subsidiary received estimated $117M in overpayments in 2015

    Rylee Wilson -
    Humana subsidiary CarePlus Health Plans received $641,467 in net overpayments in 2015, an audit by HHS' Office of Inspector General published Oct. 26 found. 

  9. Centene launches co-branded Medicare Advantage plans with Mutual of Omaha

    Rylee Wilson -
    WellCare, Centene's Medicare Advantage subsidiary, will offer co-branded plans with Mutual of Omaha in 2024. 

Featured Learning Opportunities

Top 40 articles from the past 6 months