The Latest - Page 112 of 1587 - Becker's Payer Issues

The new CMS orthopedic bundle will test every program’s readiness

A mandatory bundled payment model is arriving for orthopedic care, and under CJR-X, hospitals and health systems will be accountable for the total cost and quality of each episode — whether or not they are prepared. Programs that misjudge their…

Aug 27, 2026 1:00 PM - 2:00 PM CDT

Presented by:

Presenters:

P. Maxwell Courtney, MD, Chair of AAHKS Advocacy Committee Division Chief of Adult Reconstruction at Rothman Orthopedics Associate Professor, Orthopedic Surgery, Thomas Jefferson University
Stephen Engstrom, MD, MBA, AAHKS Advocacy Committee Member
Bronwyn Spira PT, MPT, Founder & CEO, Force Therapeutics

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5 Blue Cross Blue Shield updates

As 2025 earnings reports trickled out over the last several months, they showed that many Blue Cross Blue Shield companies struggled financially last year as medical and pharmacy spending climbed and squeezed profitability. Class members began receiving payouts in May…

'Medicare Advantage has never saved a penny': Democrat-led bill seeks to rein in MA

House Democrats introduced a bill July 1 targeting Medicare Advantage overpayments. Under the bill, HHS would need to exclude or adjust diagnosis codes that “are most likely to be subject to coding variation by Medicare Advantage plans,” limiting possible upcoding.…

Why disconnected point solutions keep capping value-based care performance

Too many payers run their value-based care strategy on a stack of disconnected point solutions. Chart retrieval tools don’t connect to quality alert platforms. Coding tools don’t talk to claims systems. Every vendor brings its own implementation, training and contract…

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The longevity challenge healthcare leaders can’t afford to ignore

Americans are living longer, but the healthcare system is not keeping pace. By 2030, the U.S. is projected to face a shortage of 121,900 physicians. At the same time, 63.7 percent of adults age 65 and older are managing two…

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5 things to know about Cigna's new CEO

Brian Evanko took the helm as The Cigna Group’s CEO July 1 as longtime chief David Cordani passed the baton. Mr. Evanko brings a wealth of experience across the company, including a history of executive-level leadership. He also brings his…

Optum Financial acquires benefits administration platform Alegeus

Optum Financial closed its acquisition of Alegeus Technologies, a platform offering benefits administration for consumer-directed healthcare accounts, July 2. Optum Financial is the financial services branch of UnitedHealth Group’s Optum subsidiary. Alegeus administers benefits across health savings accounts, flexible spending accounts,…

New report: AI is coming to telehealth, and health systems are preparing

Telehealth is no longer a workaround; it is core infrastructure for how care gets delivered. In one industry survey, 93% of organizations reported an active telehealth program, and 69% have run one for three years or more. Drawing on that…

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Elevance sues CMS over 2026 star ratings following Clover win

Elevance Health is suing CMS over its 2026 Medicare Advantage star ratings, arguing the agency gave competitor Clover Health a favorable recalculation after losing a court case to the insurer in May. In its July 1 complaint filed in the…

Share of Medicare Advantage enrollees in bonus-eligible plans falls to 68%

The share of Medicare Advantage enrollees in plans that qualified for federal quality bonus payments dropped to 68% in 2026, its lowest point since 2018, according to a KFF analysis published July 1. Five things to know: 1. The drop…