Today's Top 20 Stories
  1. COVID-19 vaccine coverage issues resolved, payer execs say

    Private insurers are covering the full cost of COVID-19 vaccines for beneficiaries this fall, payer executives told HHS Secretary Xavier Becerra. 
  2. Mass General Brigham Health Plan taps VP of marketing

    Mass General Brigham Health Plan has named Deb Jorge as vice president of marketing.
  3. GuideWell names CVS Caremark exec as CFO

    GuideWell has named Jeff Goddard as CFO. 

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. Aetna Medicare CMO departs for dementia care platform

    Rippl Care, a startup dementia care provider, has named Jamie Sharp, MD, as chief medical officer. 
  2. OIG: 4 states received increased Medicaid funding despite unallowable terminations

    Four states received increased federal Medicaid funding during the COVID-19 pandemic, though they may have terminated beneficiaries' coverage in violation of continuous coverage rules in place during the public health emergency, an audit by HHS' Office of Inspector General found. 
  3. UCHealth Plan Administrators joins Intermountain's Select Health

    UCHealth Plan Administrators is joining Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health that serves more than 1 million members across Utah, Idaho and Nevada.
  4. Medicare Advantage premiums to remain stable in 2024

    Medicare Advantage and Medicare Part D premiums, benefits and plan choices won't be changing much in 2024, CMS said Sept. 26.

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 to cut 2,000 jobs

    Centene is laying off about 2,000 employees starting Oct. 2, or about 3 percent of its workforce, as the company faces financial difficulties over Medicaid redeterminations and Medicare Advantage star ratings, the St. Louis Business Journal reported Sept. 26.
  2. Looming government shutdown could disrupt Medicaid redeterminations

    A government shutdown could cause hiccups in the unwinding of Medicaid continuous coverage requirements. 
  3. Cano Health sells Texas, Nevada primary care centers to Humana for $66.7M

    Miami-based primary care provider Cano Health is selling the bulk of its centers in Texas and Nevada.
  4. Cigna to pay $150K to settle alleged Virginia billing violation

    Cigna agreed to pay $150,000 to settle allegations from the Virginia Bureau of Insurance that it violated state law by failing to provide required balance billing disclosures. 

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. BCBS Louisiana, Elevance Health halt $2.5B acquisition

    Blue Cross and Blue Shield of Louisiana's sale to Elevance Health for $2.5 billion is temporarily on hold, reported Sept. 25.
  2. What 1 Aetna regional president recommends for successful value-based arrangements

    Building and maintaining successful value-based care arrangements is difficult and will require innovative thinking from leaders across the healthcare spectrum, according to Aetna's Southeast region president, Rich Weiss.
  3. Ohio hospital drops Anthem Medicare Advantage, Medicaid plans

    Adena Regional Medical Center is terminating its contract with Anthem BCBS' Medicare Advantage and managed Medicaid plans in Ohio, effective Nov. 2.  
  4. Lawsuits pile up against Cigna over alleged mass claim denials

    The Cigna Group is facing a growing number of lawsuits from members and a shareholder following a ProPublica report that alleges the company denies large batches of members' claims without individual review, thereby denying them coverage for certain services.
  5. Lawmakers propose bill to automatically enroll children in Medicaid

    Proposed legislation would automatically enroll all children under age 18 in Medicaid. 
  6. 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. 
  7. 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. 
  8. 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. 
  9. 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. 

Top 40 articles from the past 6 months