Author: Jakob Emerson

Blue Cross and Blue Shield of North Carolina has named Kelly Calabria as senior vice president, chief marketing and corporate social responsibility officer, effective Aug. 15.

After a pandemic exposed inefficiencies the healthcare system has faced for decades, the trend toward value-based payment models for in-home care and accounting for social determinants of health is more important than ever, according to Eric Galvin.

A suburban Chicago physician is facing up to 10 years in federal prison after being charged July 12 with one count of healthcare fraud against Blue Cross Blue Shield of Illinois and Medicare.

Cleveland Clinic is working to get New York state to conduct an independent external review of a Bronx man's rare cancer diagnosis and recommended multi-organ transplant after Empire Blue Cross Blue Shield denied coverage, WPIX reported July 12.

West Virginia University Medicine's new Peak Health plan will become a Medicare Advantage and Medicaid managed care provider in the state, MetroNews reported July 12.

Aetna has dropped its policy to not cover cardiac PET/CT scans following a joint letter from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging.

XSOLIS has named Jamie Kiggen CFO and Michael Drescher as vice president of payer strategy.

Florida's Department of Management Services is now accepting bids from payers to manage its $3.12 billion state employee health plan that covers about 170,000 people, according to Florida Politics.

San Diego-based Turquoise Health and San Francisco-based Komodo Health are partnering to create a platform that will allow patients to understand the full cost of healthcare services and help streamline payer-provider contracts.

The majority of fee-for-service Medicare and Medicare Advantage members largely don't understand their coverage policies, leading to the widespread risk of enrollees who are in plans that don't fit their health or financial needs, according to a new report from…