The broader health insurance industry has announced a series of commitments to streamline, simplify and reduce prior authorization requirements across commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans. “The health care system remains fragmented and burdened by…
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CMS will raise limits for payments to Medicare Advantage brokers for 2026. According to a notice from CMS published June 18, plans can pay brokers up to $694 for new enrollments in MA plans, and $347 for renewing existing members.…
New York City Mayor will not implement an Aetna Medicare Advantage plan for its retirees, Mayor Eric Adams said June 20. “We have heard concerns from retirees about these potential changes at numerous older adult town halls and public events,…
CMS is implementing a final rule that will shorten the open enrollment period on the ACA exchange and create stricter eligibility verifications for enrollees. In a June 20 news release, the agency said the changes will lower individual premiums by…
The Trump administration and insurers appear to have their own changes to reimbursement practices in store, with announcements expected next week — adding to funding changes outlined in Congress’ budget reconciliation bills. The Wall Street Journal reported June 20 that…
Medicare Part A will no longer be able to pay the total cost of Medicare beneficiaries hospital costs by 2033, according to the annual Trustees Report. The date is three years sooner than the trustees predicted in 2024. The annual…
Today’s prescribing process is a maze. Providers can’t see what drugs are covered. Patients don’t know what they’ll owe. The result? Poor adherence, worse outcomes and lost pharmacy revenue. During a recent Becker’s-hosted advisory call, leaders in pharmacy, finance and…
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Most health systems still rely on outdated communication workflows that frustrate patients and overextend staff. Calls go unanswered, wait times grow and teams can’t keep up. These breakdowns are more than operational. They directly impact access, satisfaction and care continuity.…
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John Poli
Industry Principal, Healthcare, RingCentral
At Becker’s 15th Annual Meeting, leaders from Microsoft and Blue Shield of California shared how AI is one tool to help transform payer operations — not by replacing humans, but by personalizing care, cutting friction and restoring trust. Christine McKinney,…
After the pandemic, leaders at Jefferson Health knew that their teams needed help. However, meeting the behavioral health needs of their workforce presented a challenge of access and scale. Jefferson Health faced this challenge head-on by integrating Marvin Behavioral Health’s…
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