Clover Health’s PPO, the company’s largest contract covering 97% of members, already secured a Medicare Advantage star ratings boost from 3.5 to 4.5 stars following litigation. Now, the insurer’s smaller HMO contract is also seeing a bump. According to a…
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Twenty-four percent of maternal health providers on Medicaid managed care network lists sent to states are not actually in network, according to the HHS Office of Inspector General. These listings are commonly referred to as “ghost providers,” meaning they appear…
Filling an open physician role costs more than $500,000. Yet only 39% of healthcare organizations have a formal retention policy and most aren’t using retirement benefits as the differentiator they could be. The problem is that traditional 401(k) plans offer…
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Patient expectations keep climbing while clinical teams absorb a steady load of nonclinical requests, repeated questions and unclear bedside communication. Moving satisfaction scores without adding headcount has become one of the hardest problems in hospital operations. Penn Medicine’s Clifton Center…
Jul 21, 2026 12:00 PM - 1:00 PM CDT
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Presenters:
- Braheem Santos, US Segment Sales & Market Leader, Healthcare, Schneider Electric
- John Donohue, Vice President, Data and Technology Solutions, Penn Medicine, Penn Medicine
Four in ten U.S. adults have skipped doses, delayed refills, or left a prescription unfilled because of cost, and six in ten now worry about affording their medications. Affordability is usually framed as a patient access issue, but it’s also…
Jul 20, 2026 12:00 PM - 1:00 PM CDT
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Presenters:
- Srulik Dvorsky, Co-Founder and CEO, TailorMed
- Ashley Barrett, Director Financial Clearance Authorization Services, Moffitt Cancer Center
- Edwina Williams, MBA, System Manager, Patient Assistance Programs, SSM Health
Pharmacy benefit managers Abarca Health and LucyRx are merging, the companies said in a June 17 news release. Together, the organizations will reach 9 million members. The companies will operate as subsidiaries under Healthcare Revolution Partners. The news release said…
Mark Cuban disrupted pharmaceutical pricing in 2022 with Cost Plus Drugs, a public benefit corporation that charges a flat 15% markup on generics and posts its full price list publicly, bypassing pharmacy benefit managers and intermediaries entirely. Four years later,…
A federal judge has denied an emergency request by Montgomery, Ala.-based Jackson Hospital, which filed for bankruptcy in February, to force Blue Cross Blue Shield of Alabama to raise its reimbursement rates to match area hospital Baptist Medical Center South. …
The Pharmaceutical Care Management Association, a trade group for pharmacy benefit managers, filed lawsuits in June challenging Illinois and Tennessee pharmacy laws. PCMA raised Employee Retirement Income Security Act-based preemption counts targeting Illinois’ Prescription Drug Affordability Act. The law, signed…
Many DSOs have already invested in automation. Few have figured out how to manage it at scale. What worked across five locations often breaks at 50. As multi-site organizations grow, inconsistent workflows across patient and payer payment processes, limited visibility…
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Presenters:
- Manu Chaudhry, DDS, President, Capitol Dental Care
- Camie Worley, COO, Emergency Dental of America
- Haim Haviv, MBA, CEO, Hudson Dental
- James Swan, MBA, Sr. Director, Enterprise Solutions, Rectangle Health
- Ray Caruso, President and Chief Executive Officer, Lone Peak Dental Group