Behind every cancer diagnosis is a person facing one of life’s most frightening experiences, often confused about next steps, uncertain where to turn, and racing against time. In 2026, more than 2 million Americans are likely to be diagnosed with…
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The expiration of enhanced subsidies at the end of 2025 altered the marketplace. In 2026, enrollment dropped, and the remaining risk pool became older and sicker. Over the summer, a Peterson-KFF Health System Tracker analysis found that insurers had requested…
Many clinicians already use AI assistants at work. The open question for health system leaders is which one to put in every clinician’s hands. That choice goes beyond features and price. It comes down to trust, safety, and how well…
Presented by:
- Matt Troup, PA-C, Clinical Strategy Principal, Abridge
- Adriel Kramer, MD, Chief Medical Information Officer, Middlesex Health
- Abiodun Omoloja, MD, Chief Medical Informatics Officer, Dayton Children’s Hospital
Horizon Blue Cross Blue Shield of New Jersey has agreed to acquire multispecialty physician group Summit Health’s New Jersey operations, including CityMD urgent care sites in the state, the insurer confirmed to Becker’s. “We are excited by the opportunity to…
Newly enabled competition between Blue Cross Blue Shield plans is continuing to contribute to Elevance Health’s commercial insurance business, leadership said on the company’s quarterly earnings call Oct. 21. Dubbed the “second blue bid,” the provision stems from a $2.67…
PacificSource is laying off 134 employees in Oregon, its second round of cuts this year tied to the insurer’s decision to exit Montana and the individual line of business. The layoffs, effective Dec. 31, will affect offices in Bend, Portland,…
Health plans are under pressure to grow membership without eroding the margins that keep them competitive. Local markets shift fast, and the line between a promising opportunity and a costly distraction is rarely obvious. Enter the wrong market, and the…
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Presented by:
- Jay Sivasailam, VP of Healthcare Strategy, Data Axle
Amazon, Axon, Google, Meta and Oracle are asking the insurers and third-party administrators that run their health plans to expand electronic prior authorization upgrades, first promised under a 2025 federal pledge, to the self-funded market. CMS and the Labor Department…
As Elevance Health prepares to implement new site-of-care billing requirements, revenue cycle leaders are raising concerns about additional administrative burdens, potential payment delays and growing complexity across payers. “My broader concern is growing variation across payers, which adds cost and…
The Medicaid landscape is radically shifting, and some managed care organizations have questioned whether it is sustainable to continue in certain markets. When redeterminations restarted in April 2023 after the pandemic, average acuity increased, according to a February white paper…
