Today's Top 20 Stories
  1. Florida Blue, BayCare resolve contract dispute days before deadline

    BayCare will stay in-network with Florida Blue, reaching an agreement days before the organizations in-network contracts were set to expire, BayCare said Sept. 28. 
  2. Blue Health Intelligence names vice president of product management

    Blue Health Intelligence, the Blue Cross Blue Shield Association's data analysis affiliate, has named Divya Srungaram as vice president of product management. 
  3. Cambia Health Solutions names chief marketing officer

    Cambia Health Solutions has named Tracy Wiese as chief marketing officer. 

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  1. MetroPlusHealth names chief of government relations, strategic partnerships 

    MetroPlusHealth has named Erin Drinkwater as its first chief of government relations and strategic partnerships.
  2. Illinois health system won't commit to see Aetna Medicare Advantage members without a contract

    Carle Health in Urbana, Ill., said it won't commit to treating Aetna Medicare Advantage members, the only health plan offered to Illinois state retirees, until it has a contract with the insurer, The News-Gazette reported Sept. 28.
  3. Molina Healthcare of Florida suspends prior authorizations during Hurricane Ian

    Molina Healthcare of Florida is suspending prior authorization requirements to assist members and providers affected by Hurricane Ian. 
  4. HHS approves Medicaid programs in 2 states to address food insecurity, extend childhood coverage

    HHS approved plans to test Medicaid coverage of medically-tailored meals and other nutritional services in Massachusetts and Oregon, the agency said Sept. 28. 

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  1. 25 best-rated Medicare plans in 2022

    The National Committee for Quality Assurance has named the top-performing Medicare plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.
  2. 13 best-rated Medicaid plans in 2022

    The National Committee for Quality Assurance has named the top-performing Medicaid plans of 2022 based on factors that include care quality, patient satisfaction and efforts to keep improving.
  3. Nevada's future public health plan could save the state $1.3B, report finds

    Nevada's public health plan set to launch in 2026 could save the state up to $1.3 billion in healthcare costs over the following decade, according to a state report released Sept. 23.
  4. Transforming the traditional utilization management process with AI

    Utilization management (UM) has become a huge administrative burden for both providers and payers due to multiple data sources and manual processes. By using artificial intelligence (AI) technology and real-time data, all parties can significantly reduce current utilization management review time.

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  1. CareSource names CEO of Arkansas market

    CareSource has named David Donohue CEO of the Arkansas market, where he will lead PASSE, the company's value-based delivery program for Medicaid patients.
  2. 'COVID has shattered actuarial science': Incoming Clover Health CEO lays out his priorities, challenges

    Clover Health President and Chief Technology Officer Andrew Toy will assume the role of CEO in January when founder Vivek Garipalli moves on from the position. 
  3. ACA contraceptive coverage requirements are confusing, healthcare attorneys say

    The Health Resources and Services Administration should do more to clarify which contraceptives are required to be covered at no cost under the ACA and make sure new methods are added to coverage requirements, healthcare attorneys write in an opinion for Health Affairs. 
  4. Cigna launches Pathwell service for managing chronic conditions

    Cigna is launching a new concierge service, Pathwell, combining elements from Evernorth, its health services arm, to treat complex conditions. 
  5. Retiree advocacy group sues Delaware over switch to Medicare Advantage plan

    A Delaware retiree advocacy group is suing the state over its decision to move retired state employees to a Medicare Advantage plan managed by Highmark Delaware, Delaware Public Radio reported Sept. 27. 
  6. BCBS Michigan quietly selling Advantasure subsidiary

    Blue Cross Blue Shield of Michigan is quietly selling its healthcare technology subsidiary Advantasure for an undisclosed amount to health plan administrator UST HealthProof.
  7. First Choice Health names 2 vice presidents

    First Choice Health, a Seattle-based PPO network and health benefits administrator, has named Hillary Galyean as vice president of enterprise account management and David Agler, MD, as vice president of medical management.
  8. Independence Blue Cross, Penn Medicine partner on value-based care through co-ownership of Tandigm Health

    Independence Blue Cross and Penn Medicine are partnering on a value-based primary care model centered around co-ownership of Blue Cross' physician network subsidiary, Tandigm.
  9. Cigna dropping paperwork demand after pushback from CMA, AMA

    Cigna will not implement a paperwork demand that was criticized by the California Medical Association and American Medical Association. 

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