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Alliance of Community Health Plans President and CEO Ceci Connolly sees momentum around risk adjustment reform picking up. “We see this administration taking very seriously the concerns over wide gaps in risk adjustment payments — gaps that are far outside…

Specialty drug growth is accelerating, but billing infrastructure has not kept pace. High-cost therapies now represent a growing share of total drug spend and pipeline volume. At the same time, medical benefit claims, prior authorizations, payer policy changes and 340B…

Mar 26, 2026 12:00 PM - 1:00 PM America/Chicago

Presented by:

Presented by

Presenters

David Pope, PharmD

Chief Pharmacy Officer XiFin, Inc.

Mike Fauver

Vice President, Enterprise Solutions XiFin, Inc.

Heather Agostinelli

Vice President, Head of Specialty RCM XiFin, Inc.

Mar 26, 2026 12:00 PM - 1:00 PM America/Chicago

Presented by:

Presented by

Presenters

David Pope, PharmD

Chief Pharmacy Officer XiFin, Inc.

Mike Fauver

Vice President, Enterprise Solutions XiFin, Inc.

Heather Agostinelli

Vice President, Head of Specialty RCM XiFin, Inc.

From Optum launching a pair of prior authorization tools to UnitedHealthcare projecting it will lose up to 2.8 million members in 2026, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since Jan. 14: 1.…

CVS Health’s approximately 9,000 community pharmacies began accepting TrumpRx discount cards Feb. 6. The cards offer savings on certain medications for eligible patients, as determined by drugmakers, according to a Feb. 6 CVS news release. Patients can present printed discount…

CMS released participation data Feb. 4 for Medicare accountable care organizations in 2026, showing continued growth in enrollment and a record number of beneficiaries served by the Shared Savings Program. Six things to know:

UnitedHealth’s Optum identified $1.7 billion in potential savings if Minnesota would remedy ambiguity in its Medicaid policies, according to a Jan. 31 from the company.  As of October, the Minnesota Department of Human Services had contracted with Optum to analyze claims…

This February, BCBS Michigan shared how it will cut reimbursement by 50% for nonpreventive evaluation/management services with modifier 25 that were billed on the same day as procedure codes with global periods of zero, 10 or 90 days. Modifier 25…

Elevance Health bid on 11 national accounts in competing Blue Cross Blue Shield markets last year and won nine of them, the company said on its 2025 earnings call with investors, offering the first look at how a landmark antitrust…

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