Today's Top 20 Stories
  1. Humana saved $8B though value-based care in 2022

    Humana's value-based care efforts in Medicare Advantage saved around $8 billion in 2022 compared to traditional Medicare, according to the company's annual value-based care report published Nov. 15. 
  2. Cigna, MUSC strike new deal

    Charleston, S.C.-based MUSC Health and Cigna have reached a new contract agreement just weeks before their contract was set to expire, The Post and Courier reported Nov. 14. 
  3. UnitedHealth faces lawsuit over AI, Medicare Advantage care denials

    UnitedHealth Group and its health insurance arm, UnitedHealthcare, are facing a proposed class-action lawsuit alleging an AI algorithm wrongfully denied Medicare Advantage patients care. 

The state of AI in healthcare

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  1. 5 states considering adding weight loss drug coverage under Medicaid

    At least five states are considering adding coverage of weight loss drugs to their Medicaid program, according to KFF's 2023 survey of state Medicaid directors. 
  2. Humana to open 4 CenterWell clinics in Indianapolis

    Humana will open four CenterWell clinics in Indianapolis in 2023 and 2024, the company said in a Nov. 14 news release. 
  3. CEO of Kentucky's best Medicaid plan on how partnerships lead to quality

    Aetna Better Health of Kentucky CEO Paige Mankovich is zeroing in on improving specific disease states and building health at the community level. 
  4. 10 providers seeking payer contracting talent

    Ten providers recently posted job listings seeking leaders in payer contracting and relations.

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Justice Department dropping antitrust case against UnitedHealth's SCA Health

    The Justice Department is asking a Texas federal court to dismiss its case against SCA Health that alleged the company agreed with competitors not to poach senior-level employees.   
  2. Significant role for AI 'unlikely to emerge immediately' for payers: Moody's 

    Artificial intelligence offers enormous potential for positive change within the health insurance industry, but like the integration of data analytics, that change will take time and be more pronounced in certain areas over others in the short-term, according to an October report from Moody's.
  3. Former Centene COO to lead Sharecare

    Brent Layton, senior adviser to the CEO at Centene, has been named CEO of digital health company Sharecare. 
  4. AMA calls on insurers to cover weight loss drugs

    The American Medical Association is urging insurers to cover the cost of new weight loss medications. 

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. Florida Blue CEO to chair AHIP board

    Pat Geraghty, president and CEO of Florida Blue and parent company GuideWell, will chair AHIP's board of directors beginning in 2024. 
  2. UnitedHealth provides humanitarian aid to Israel, Gaza

    The United Health Foundation is donating $1 million toward humanitarian aid for civilians affected by the ongoing Israel-Hamas war. 
  3. How Allina Health | Aetna avoids negotiation 'quibbles'

    As a provider-integrated plan, Allina Health | Aetna can focus on quality rather than network negotiations, Chief Medicare Officer Britta Orr says. 
  4. Intermountain's health plan aims to end PBM 'games' through Cuban partnership

    Intermountain Health's insurance arm, Select Health, has rolled out a new partnership with Mark Cuban's Cost Plus Drug Co. to its more than 1 million members — a move its chief pharmacy benefits officer said is aimed at eliminating "all the games" in the PBM marketplace.
  5. Health Care Service Corp. rebrands Trustmark Health Benefits 

    Health Care Service Corp. has rebranded Trustmark Health Benefits to Luminare Health.
  6. What 4 recent studies found about Medicare Advantage

    Medicare Advantage enrollees tend to have lower hospital readmissions rates and expenses than their counterparts in fee-for-service, studies have uncovered. 
  7. Medicaid in the headlines: 7 recent updates

    More than 10 million people have been disenrolled from Medicaid through the redeterminations process, and plans are facing fines for violating mental health parity laws. 
  8. BCBS Association: ACA risk adjustment is working

    ACA marketplace risk adjustment payments are working as intended, an analysis from Oliver Wyman, commissioned by the Blue Cross Blue Shield Association, found. 
  9. BCBS Association sued over alleged disclosure of federal employee data to TikTok 

    The Blue Cross Blue Shield Association allowed federal employees' sensitive medical information to be obtained by third-party technology companies, including TikTok, according to a lawsuit filed Nov. 7 in a federal court in Chicago.

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