Today's Top 20 Stories
  1. Payers are concerned about gene-therapy drug costs: 5 things to know

    Payers are anticipating the cost of expensive new gene therapy drugs to be a significant issue in the coming years, according to a survey from the Pharmaceutical Strategy Group. 
  2. 26 state attorneys general urge Medicare to cover Alzheimer's treatments

    Twenty-six state attorneys general are asking Medicare to cover monoclonal antibody treatments for Alzheimer's disease. 
  3. Georgia signs state-run ACA exchange into law

    Georgia Gov. Brian Kemp signed legislation May 2 that establishes a state-managed ACA exchange, pending approval from CMS.

A new framework for measuring RCM success — Insights from Denver Health

RCM optimization isn't cheap — but what hospitals really can't afford is sticking to the status quo. Discover how this safety-net hospital is advancing digital transformation in RCM here.
  1. Montana judge halts rule requiring prior authorization for Medicaid-paid abortions

    A Montana judge is temporarily halting a rule that would require prior authorizations for Medicaid-paid abortions, the Daily Montanan reported May 1. 
  2. Former Express Scripts headquarters to be auctioned

    A vacant office building that previously was part of Express Scripts' headquarters is being auctioned, the St. Louis Business Journal reported April 27. 
  3. Blue Shield of California appoints senior vice president of health transformation

    Blue Shield of California has named Krishna Ramachandran as senior vice president of health transformation and provider adoption. 
  4. UnitedHealthcare ordered to pay Envision $91M in billing dispute

    Arbitrators sided with physician services company Envision Healthcare in its dispute with UnitedHealthcare over allegations the payer breached their contract by reducing reimbursement rates. 

5 signs it's time for end-to-end RCM

There are 5 signs that it's time to switch to end-to-end RCM. Learn what they are + solutions here.
  1. Medicare Advantage in the headlines: 7 recent updates

    Bright Health is moving to sell the last of its Medicare Advantage business, and new enrollments are boosting payers' first-quarter earnings. 
  2. How Blue Cross Blue Shield of Arizona is changing behavioral health numbers and narratives

    I have held titles throughout my life and career that reinforce my commitment to healthcare and caring. I’m the chief medical officer at Blue Cross Blue Shield of Arizona, former director of the Arizona Department of Health Services, and above all – I’m a mom. 
  3. Medicare Advantage enrollment has surpassed traditional Medicare

    Medicare Advantage enrollment has surpassed traditional Medicare for the first time in the program's history.
  4. Elevance Health, Molina execs appointed to MACPAC

    Executives from Elevance Health and Molina Healthcare are among the six new members appointed to the Medicaid and CHIP Payment and Access Commission. 

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. Clover Health's 5 highest-paid executives

    Clover Health CFO Scott Leffler was paid $13.5 million in total compensation in 2022, according to regulatory filings published April 26. 
  2. Cigna names Montefiore Medicine CEO to board

    Cigna has appointed New York City-based Montefiore Medicine's president and CEO to its board of directors.
  3. BCBS Vermont looks to become subsidiary of BCBS Michigan

    Blue Cross Blue Shield of Michigan is planning to bring on Blue Cross and Blue Shield of Vermont as a subsidiary.
  4. Oscar Health's highest-paid executives

    Oscar Health interim CFO Siddhartha Sankaran was the company's highest-paid employee in 2022, according to regulatory filings published April 27. 
  5. BCBS Tennessee selling 11-acre Chattanooga campus

    BlueCross BlueShield of Tennessee has listed an 11-acre campus in Chattanooga for sale, the Chattanooga Times Free Press reported April 28. 
  6. UnitedHealth in the headlines: 12 updates

    From releasing its first quarter earnings to its Optum arm purchasing a multispecialty physician group, here are 12 UnitedHealth updates Becker's has reported since April 10:
  7. More enrollees choosing higher-premium Medicare Advantage, Part D plans

    The average premium cost for Medicare Advantage plans sold on eHealth increased from $6 a month in 2022 to $9 in 2023, according to the online insurance marketplace's annual "Medicare Index Report." 
  8. 4 ways ChatGPT can boost health insurance processes

    ChatGPT has made headlines across healthcare in recent months, and insurers are no exception to organizations that can use the tool to automate and streamline internal and external processes.
  9. Molina reports $321M profit in Q1

    Molina Healthcare reported double-digit growth in net income since the same period last year and raised its year-end earnings guidance, according to the company's first-quarter earnings posted April 26.

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