Today's Top 20 Stories
  1. Top Humana exec departs after 3 decades

    Humana's chief corporate affairs officer, William Fleming, PharmD, is leaving the company after a 30-year tenure.
  2. 20 payers among best companies to work for disability inclusion in 2024

    Twenty payers have been recognized for their initiatives around disability inclusion and equality for their employees in the 2024 Disability Equality Index, a national benchmarking survey created by Disability:IN and the American Association of People with Disabilities.
  3. Florida Blue, Sanitas plan more primary care clinics

    Florida Blue and Sanitas Medical Center are planning three more primary care clinics in Jacksonville, Fla., the Jacksonville Daily Record reported July 16. 

The state of AI in healthcare

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  1. AI saving costs for UnitedHealth, CEO says

    UnitedHealth Group's CEO expects artificial intelligence to create a "fundamental reimagination" of business processes. 
  2. UnitedHealth: Medicaid 'mismatch' will be short-lived

    UnitedHealth Group executives told investors pressure on Medicaid margins from redeterminations is likely to be short-lived. 
  3. UnitedHealth posts $4.2B profit in Q2

    UnitedHealth Group posted $4.2 billion in net income during the second quarter of 2024, a 23% decline year over year.
  4. 8 payers sign on to Washington's value-based care pact

    Eight payers have signed an agreement to promote value-based payment models in Washington state. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Arrests made during protest outside UnitedHealthcare headquarters

    Eleven people were arrested July 15 during a protest outside UnitedHealthcare's headquarters in Minnetonka, Minn., the Star Tribune reported.
  2. Court sides with Aetna over BCBS for North Carolina state health plan

    A North Carolina state court has sided with the state in its decision to award Aetna its health plan contract for public employees over Blue Cross Blue Shield of North Carolina.
  3. BCBS and Medicare Advantage: 7 updates

    From new star ratings to market departures, these are seven recent Blue Cross Blue Shield updates involving Medicare Advantage:
  4. Elevance Health plans primary care clinic partnership

    Elevance Health struck a deal with Astrana Health to operate clinics for Anthem Blue Cross members in California. 

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. Centene board beats $1.3B Medicaid fraud lawsuit 

    Current and former Centene board members, along with former senior executives, have beat a pension fund derivative lawsuit alleging the company overbilled state Medicaid programs for pharmacy services.
  2. Trial underway in Florida Medicaid redeterminations challenge

    A trial is underway to determine if Florida failed to properly notify Medicaid beneficiaries it disenrolled during the unwinding process, the Miami Herald reported July 11.  
  3. CMS cites Aetna in 1st No Surprises Act audit

    Aetna failed to accurately calculate qualified payment amounts for air ambulance services, CMS' first audit of an insurer's No Surprises Act compliance found. 
  4. AI a higher investment priority for payer CFOs

    Investing in digital and artificial intelligence technologies is a higher priority for payer CFOs than for their health system counterparts, according to a July 10 report from Deloitte.
  5. Highmark loses 26,000-member contract

    The largest health insurance purchaser in Western New York will award its employee health plan to Univera Healthcare, Buffalo News reported July 11. 
  6. Medicare Advantage in the headlines: 10 recent updates

    CMS published updated star ratings for dozens of Medicare Advantage plans, and a federal judge paused a new CMS regulation that would cap the amount insurers can pay brokers who sell their plans. 
  7. Illinois gov. signs prior authorization reform bill

    Illinois Gov. JB Pritzker has signed a pair of health insurance reform bills into law.
  8. BCBS Louisiana switches to Epic

    Blue Cross and Blue Shield of Louisiana has moved its care management processes and several provider services to the Epic Payer Platform. 
  9. Payers confronted by COVID vaccine lawsuits

    One Blue Cross Blue Shield plan has lost in federal court for terminating an employee that refused to get vaccinated against COVID-19, and other insurers are facing similar lawsuits.

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