Today's Top 20 Stories
  1. Providence Health Plan makes 3 changes to C-suite

    Providence Health Plan has named a chief administrative officer, chief growth officer and chief healthcare experience and equity officer.
  2. Kraft Heinz drops claims data lawsuit against Aetna

    Kraft Heinz has voluntarily dismissed a lawsuit against Aetna alleging the payer breached its fiduciary duties and used its role as third-party claims administrator for Kraft's employee health plan "to enrich itself" to the food manufacturer's detriment.
  3. 5 Medicare Advantage changes coming in 2024

    CMS will implement new risk adjustment payment rates, prior authorization requirements and network standards for Medicare Advantage plans in 2024. 

The state of AI in healthcare

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  1. Elevance Health, BCBS Louisiana acquisition back on

    Blue Cross and Blue Shield of Louisiana and Elevance Health have submitted a new proposal to the Louisiana Department of Insurance to allow the nonprofit insurer to be bought by Elevance, nola.com reported Dec. 15. 
  2. The cities with the most competitive Medicare Advantage markets | 2023

    Almost three-quarters of the nation's local Medicare Advantage markets are highly concentrated, according to the American Medical Association. 
  3. 'It's going to help us do it all': What excites Elevance Health's global CIO most about AI

    Artificial intelligence is nothing new in the world of health insurance, but the speed and scale of its implementation across the industry are ramping up.
  4. 21 Elevance Medicaid plans recognized for advanced health equity efforts

    Elevance Health's managed Medicaid plans in 21 states have been recognized by the NCQA for their advanced health equity efforts.

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Cambia makes 3 changes to C-suite 

    Cambia Health Solutions has named a chief commercial officer, a president and CEO of its TPA subsidiary, and promoted its CIO to executive vice president, effective Jan. 1.
  2. The cities with the most competitive commercial insurance markets | 2023

    Almost half of the nation's local commercial insurance markets are majority controlled by one payer, according to the American Medical Association. 
  3. 2 ASCs seek COVID-19-era reimbursements from Arkansas BCBS

    Two Little Rock, Ark.-based ASCs are seeking potentially millions of dollars in unpaid reimbursements from Arkansas Blue Cross and Blue Shield for procedures performed during the COVID-19 pandemic, Arkansas Business reported Dec. 11.  
  4. 45% of employer group market can be disrupted, Centene CEO says

    Centene CEO Sarah London foresees major disruption opportunities ahead in the employer group insurance market by way of individual marketplace coverage.

How one Midwest hospital is driving financial efficiency with interconnected systems

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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. Humana used AI tool from UnitedHealth to deny Medicare Advantage claims, lawsuit alleges

    Humana used an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare Advantage members' medical claims, according to a class-action complaint filed Dec. 12.
  2. Quartz names CEO

    Quartz has named Christine Senty president and CEO after serving in the position on an interim basis since April.
  3. 10 providers seeking payer contracting talent

    Ten providers recently posted job listings seeking leaders in payer contracting and relations.
  4. UnitedHealth Group in the headlines: 12 updates

    From its Optum arm adding nearly 20,000 physicians in 2023 to outlining its 2024 revenue expectations, here are 12 updates on UnitedHealth Group that Becker's has reported since Nov. 27: 
  5. BCBS Michigan CEO reflects on his 17-year legacy

    One of Blue Cross Blue Shield's longest-serving CEOs is looking toward retirement after 17 years. 
  6. Centene projects $142.5M+ in 2024 revenue, announces $4B stock repurchase program

    Centene expects 2024 revenues to be at least $142.5 billion
  7. UnitedHealth exec named AHIP’s next CEO

    Mike Tuffin, senior vice president of external affairs at UnitedHealth Group, will be AHIP's next CEO.
  8. The trends 26 payer executives are watching

    Payer executives are keeping a close eye on artificial intelligence, drug costs, behavioral health and more in 2024. 
  9. Cigna still exploring Medicare Advantage sale: Report

    Although its merger with Humana has fallen through, Cigna is still considering the sale of its Medicare Advantage business, The Wall Street Journal reported Dec. 10. 

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