Today's Top 20 Stories
  1. BCBS Tennessee names new Medicare executive

    BlueCross BlueShield of Tennessee has named Jason Habich as vice president and general manager of Medicare, according to an October LinkedIn post.
  2. BCBS Massachusetts snags divisional UnitedHealth CFO

    Blue Cross Blue Shield of Massachusetts has named Ruby Kam as its new CFO. 
  3. Feds to limit predictive tools for Medicare Advantage

    The federal government will restrict how Medicare Advantage plans use predictive technology tools to make some coverage decisions, KFF Health News reported Oct. 5.

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. Lawmakers want feds to 'carefully scrutinize' UnitedHealth's Amedisys acquisition

    A pair of lawmakers are calling on the Federal Trade Commission and the Justice Department's antitrust division to "carefully scrutinize" UnitedHealth Group's proposed $3.3 billion acquisition of home and hospice care provider Amedisys.
  2. Point32Health expands maternal health program with Brigham and Women's, Harvard

    Point32Health is bringing its TeamBirth maternal healthcare program to nine more hospitals and provider groups in Massachusetts. 
  3. How Medicaid plans can build fundamental trust with providers

    In a decade leading the Illinois Association of Medicaid Health Plans, CEO Samantha Olds Frey has worked to build managed care in the state from the ground up, winning "hard-fought" trust from providers. 
  4. 3 states dropping payers from Medicaid contracts

    Some states are opting for new providers to administer their Medicaid managed care programs. 

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. Centene in the headlines: 7 recent updates

    Centene is laying off around 3 percent of its workforce, and the company is continuing to offload its non-core business. 
  2. Why BCBS Michigan is cutting 20% of prior authorization requirements

    Blue Cross Blue Shield of Michigan intends to cut 20 percent of its prior authorization requirements. James Grant, MD, the payer's senior vice president and chief medical officer, told Becker's the changes are part of an evolving process.  
  3. Grocers with Medicare Advantage plans: 6 updates

    From Walmart and UnitedHealth Group to Instacart and Alignment Healthcare, these are six grocery companies that have launched co-branded Medicare Advantage plans with payers in the last two years:
  4. UnitedHealthcare enhances its UCard for 2024: 4 updates

    UnitedHealthcare is expanding its Medicare Advantage footprint next year and enhancing the benefits of its UCard, an integrated insurance ID card with many uses for members.

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. The top-rated Medicaid plan in every state, per NCQA

    The National Committee for Quality Assurance awarded 13 Medicaid contracts 4.5 star ratings for 2023. 
  2. Excellus BCBS appoints VP of health equity

    Excellus Blue Cross Blue Shield has named Simone Edwards, DrPH, as vice president of health equity and community investments. 
  3. BCBS Association names VP of clinical affairs 

    The Blue Cross Blue Shield Association has named Razia Hashmi, MD, as vice president of clinical affairs.
  4. Southeast Georgia Health System to end Medicare Advantage contract with Centene subsidiary

    Brunswick-based Southeast Georgia Health System will terminate its contract with the WellCare Medicare Managed Care Plan on Dec. 8. 
  5. Oregon health system threatening Medicare Advantage split strikes deal with PacificSource

    A health system that encouraged its patients to avoid Medicare Advantage plans has found common ground with at least one MA insurer. 
  6. SCAN Health Plan launches women-focused Medicare Advantage plan

    SCAN Health Plan will offer a women's health focused Medicare Advantage plan in 2024. 
  7. UnitedHealthcare expanding individual plans to 4 new states for 2024

    UnitedHealthcare will offer individual exchange plans in Wisconsin, New Jersey, New Mexico and South Carolina in 2024. 
  8. Instacart, Alignment to launch co-branded Medicare Advantage plan

    Grocery delivery company Instacart is launching a co-branded Medicare Advantage plan next year with Alignment Healthcare in 13 counties across California and Nevada.
  9. The state of Medicare Advantage in 2023: 12 notes 

    With bipartisan support in Congress and a record number of plans offered nationwide, Medicare Advantage is growing fast, diversifying its members and driving senior care costs down, according to the Better Medicare Alliance's 2023 "State of Medicare Advantage Report."

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