The Latest - Page 126 of 1587 - Becker's Payer Issues

The Multi-Location A/R Framework: Grow Revenue, Not Your Back Office

Patient balances continue to rise, but adding billing staff isn’t a sustainable answer for growing dental organizations. Many billing teams are stuck chasing payments manually, balancing patient communications across multiple locations, and trying to improve collections in a challenging labor…

Jul 29, 2026 12:00 PM - 1:00 PM CDT

Presented by:

Presenters:

Pam Draper, Vice President, Operations, Partnerships for Dentists
Samantha Champagnie, Vice President, Revenue Cycle Management, Imagen Dental Partners
Aphton McElheney, Head of Customer Success, Pearly

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Inside Aetna's push to automate claims, upskill workers, reduce friction across healthcare

When Katerina Guerraz, Aetna’s COO, stepped into her role in mid-2024, the company was having, by her own admission, a really tough year. Rather than look for incremental fixes, she and her team decided to set a new direction entirely…

Medicaid managed care is dominating: 5 notes

As of fiscal 2023, nearly three-quarters of Medicaid beneficiaries were enrolled in a full-risk managed care organization, up from less than half in fiscal 2010. On June 15, the Medicaid and CHIP Payment and Access Commission, an agency that advises…

Pharmacy’s next frontier: How AI and pharmacy intelligence are turning a cost center into a growth engine

Most health systems still treat pharmacy as a line-item expense to control. Leaders at Ochsner Health, St. Luke’s Health System, MetroHealth and Yale New Haven Health System are taking a different approach—leveraging pharmacy intelligence, AI-enabled workflows and data-driven decision-making to improve medication…

Jul 15, 2026 12:00 PM - 1:00 PM CDT

Presented by:

Presenters:

Deborah Simonson, PharmD, CPEL, Chief Pharmacy Officer and Vice President, Ochsner Health
Joshua Weber, PharmD, MBA-HCM, CSP, BCMTMS, 340B ACE, Senior Director, Ambulatory, Retail and Specialty Pharmacy Services, St. Luke's Health System
Ryan Mezinger, RPh, CPEL, Senior Vice President, Chief Pharmacy Officer, MetroHealth
Marjorie Lazarre, PharmD, MHA, Chief Pharmacy Officer, Yale New Haven Health System

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Judge vacates parts of ACA 'integrity' rule

On June 12, a Maryland federal judge vacated parts of CMS’ rule designed to govern marketplace integrity and affordability. The excised provisions include the $5 premium penalty on automatic re-enrollees, revocations of guaranteed insurance for people with past-due premiums, eligibility…

States begin collecting from CVS’s $36.5M insulin Medicaid settlement

States have begun receiving payments from CVS Pharmacy’s $36.5 million settlement over allegations that the company overbilled Medicaid programs for insulin prescriptions between 2010 and 2020. According to federal and state investigators, CVS dispensed more insulin pen cartons than prescriptions…

Centene offers buyouts to most employees

Centene is offering a voluntary separation program to employees, the company confirmed to Becker’s June 15. “Centene is positioning the company to lead the future of healthcare — working to deliver a simpler and better experience for our members and…

The hidden cost of denials: How independent practices are protecting cash flow

For independent practices, denials don’t just delay payments. They drain staff time, strain margins and create backlogs that take weeks to unwind. The financial impact is visible in A/R reports. The operational impact is felt in every billing cycle. Most…

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Presented by:

Presenter:

Michelle Scott

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Blue Cross Blue Shield plans ranked by 2025 profits

Many Blue Cross Blue Shield plans posted operating or underwriting losses in 2025 as medical and pharmacy costs climbed, but investment income lifted several of them to positive net income for the year. Combined profit margins across all BCBS plans sank to…

HCSC to launch deductible-free plans across 5 states

Health Care Service Corp. will launch a new line of commercial health plans called Edge across all five of its Blue Cross Blue Shield states beginning in 2027. The plans, powered by a proprietary plan design called Easify, have no…