The Latest

Dayton, Ohio-based CareSource suspended repayment demands it previously issued to some Ohio behavioral health providers after therapists and social workers organized public opposition to the policy change, Cleveland.com reported May 25.  The organization, Ohio’s largest Medicaid managed care plan covering…

For years, conversations about artificial intelligence in healthcare focused on how technology can support clinicians behind the scenes. But something more fundamental is starting to take shape, and it is unfolding faster than many organizations anticipated. More often, the first…

Pam Shipley, Centene’s chief strategy officer, has left the company, according to a May LinkedIn post. Ms. Shipley said she spent almost 14 years at Centene. Ms. Shipley’s first stint involved running plans in Mississippi and Georgia. She then worked…

Employers are grappling with benefits costs, which have spiked nearly 8%, the steepest annual increase in more than 10 years when excluding pandemic-era fluctuations, according to Milliman’s 2026 Medical Index. The average American with an employer-sponsored health plan is projected…

Employers’ benefits teams are playing catch-up when it comes to AI, but they plan to embrace the technology more in the coming years, according to a May 19 survey from risk-management services provider WTW. WTW’s “2026 AI Use in Health…

The Justice Department charged 15 people in Minnesota in connection with alleged fraud schemes involving more than $90 million. According to a May 21 news release from the department, the action included two of the largest Medicaid fraud cases charged…

Optum Rx has named Jon Bosland as its next chief financial officer. “The PBM space is at an inflection point with rising utilization, accelerating cost pressures, and a technology landscape that is genuinely reshaping member expectations and how value gets…