Denials remain on the rise as errors become harder to catch early and eligibility rechecks take longer. This 2025 State of Claims report — based on a survey of healthcare finance and revenue cycle professionals — identifies what is driving…
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Traditional consultants deliver reports and recommendations — then leave hospitals to figure out the rest. It’s a model that’s falling short in today’s healthcare environment. That’s why hospitals are shifting toward co-managed partnerships. These models embed clinical and operational leaders…
Presented by:
John Birkmeyer, MD
President, Medical Group, Sound Physicians
Roberta Luskin-Hawk, MD
Regional President, Sound Physicians
Melissa Buchner-Mehling, MD, CHCQM, CPHYADV, FABQAURP
Associate Chief Medical Officer, Sound Physicians
Ohio Department of Medicaid Director Maureen Corcoran is stepping down from the role, effective Oct. 31. Ms. Corcoran has served as director since January 2019, according to a Sept. 18 news release from Ohio Gov. Mike DeWine’s office. “Maureen has…
The National Committee for Quality Assurance has once again named the highest-quality and most effective health plans in the country, with Blue Cross Blue Shield of Massachusetts remaining at the top. On Sept. 16, the NCQA released its 2025 ratings…
Cincinnati-based health system TriHealth is negotiating its agreement with UnitedHealthcare as its current contract is set to expire at the end of the year, the system told Becker’s. TriHealth confirmed it sent a letter to patients addressing the potential changes…
Blue Shield of California’s new CEO, Mike Stuart, brings a finance background to the chief executive role, not only as a payer, but as the former CFO of a safety-net health system. “Working in multiple parts of the health industry…
In times of stress or transformation, open and honest communication becomes the cornerstone of team cohesion, collaboration, and trust. This session examines the real risks of poor communication and outlines a clear, practical path toward transparency, consistency, and openness at…
Presented by:
Alberto Hazan, MD, MBA
s the Senior Vice President of Envision Physician Services for the West Division and has been a practicing emergency physician for more than 18 years. He is the author of over 40 medical articles and seven novels, including Dr. Vigilante, the #1 bestselling medical thriller soon to be adapted into a television series.
Observation care is underused, inconsistently applied and frequently misunderstood — but it has a major role to play in reducing unnecessary inpatient admissions and controlling national health expenditures. This whitepaper explores how properly implemented observation care can support payer-provider alignment,…
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Gov. Kelly Ayotte prevented New Hampshire’s Executive Council from moving forward with a four-year, $27.5 million benefits contract with Anthem Health Plans of New Hampshire to cover current and retired state employees, according to Sept. 17 meeting records. The state’s…
CMS has finalized a rule requiring Medicare Advantage plans to submit provider directory data for inclusion in the Medicare Plan Finder. The change, aimed at improving transparency and beneficiary decision-making, takes effect January 1, 2026. Under the rule, MA plans…
