Picture an environment where clinicians are not chasing information, IT teams are not managing endless integrations and leaders have real-time visibility into operations across the enterprise. The promise of the “smart” hospital is not more tools, but better coordination. It…
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Elevance Health has named new presidents for its Anthem Blue Cross and Blue Shield plans in Indiana and Georgia. Amanda Free will lead Anthem BCBS of Georgia after most recently serving as vice president of local operations for the plan’s…
Humana’s board of directors declared a $0.885 per share dividend to be paid April 24. The dividend will be paid to all shareholders of record as of the close of business March 27, according to a Feb. 19 Humana news…
Medicare Advantage now covers about 55% of eligible beneficiaries nationwide — more than 35 million people — but health systems are confronting a question that until recently felt almost taboo: What happens when participation in the country’s fastest-growing Medicare program…
There’s “a hunger for a different kind of dialogue” when it comes to relations between payers and providers, according to Aetna President Steve Nelson. Mr. Nelson laid out a vision for Aetna that centers on rebuilding trust in the industry,…
Recently, payers and providers have been engaging in a slew of transparency campaigns, with some aiming to “expose” pricing and denial concerns. For example, Hospital Watch has come to the forefront, shifting blame to hospitals. “Hospital Watch is a watchdog…
Two Connecticut cities filed federal lawsuits against Cigna, CVS Health and UnitedHealth Group — targeting their pharmacy benefit managers — over an alleged “insulin pricing scheme,” according to January filings in the U.S. District Court for the state. Along with…
EmblemHealth will pay $2.5 million after an investigation by the New York attorney general’s office found the insurer violated parity laws and failed to ensure access to mental healthcare services because of inaccurate listings, also known as “ghost networks.” The office launched…
UCare is in the throes of a state takeover in Minnesota, with health systems and former employees voicing concerns over the insurer’s rehabilitation. The insurer posted an operating loss of $504 million in 2024 and shared plans to exit the…
Optum has launched Value Connect, an AI-powered platform designed to help payers and providers operationalize value-based care models by combining clinical, operational and financial data into a single system. The platform uses AI across quality measures, utilization patterns and risk…
