The Federal Trade Commission reached a settlement with Cigna’s Express Scripts in a case over alleged inflation of insulin prices, according to a Feb. 4 agency news release. With the move, the FTC expects to lower out-of-pocket costs for drugs…
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Humana saw a 24.3% decrease in inpatient admissions, or a 229,000-stay dip, for Medicare Advantage members in value-based care arrangements versus those in traditional Medicare in 2024, according to Humana’s “12th Annual Value-based Care Report,” published Feb. 4. Humana reviewed…
Sidecar Health selected Sharath Pasupunuti to serve as chief technology officer, according to a Feb. 3 news release. Mr. Pasupunuti will lead engineering, AI strategy, data and platform development in the role, scaling and updating Sidecar systems that automate claims,…
Novo Nordisk has appointed Jamey Millar, former CEO of Optum Specialty Holdings, as the drug company’s executive vice president of U.S. operations, effective Feb. 5. In the role, Mr. Millar will oversee Novo Nordisk’s largest sales region, according to Novo…
Best in KLAS is one of the most trusted and influential recognitions in healthcare technology, but what actually goes into determining the winners? In this webinar, Mac Boyter, Senior Research Director for Payer/Provider and Documentation Solutions at KLAS, offers a…
Mar 5, 2026 12:00 PM - 1:00 PM America/Chicago
Presenters
Mac Boyter
Senior Research Director, KLAS
Value-based care programs generate no shortage of insights. The problem is turning those insights into action, consistently and at scale. As downside risk grows, organizations face thousands of coordinated tasks across quality, care management and utilization management. Manual outreach, siloed…
Mar 31, 2026 11:00 AM - 12:00 PM America/Chicago
Presented by:
Presenters
Robert Connely
Global Industry Market Leader, Healthcare Pegasystems
Monique Stoner PhD, MBA
Vice President, Provider Network Management Services, Oscar Health
Bryan Waide
Director of Provider Contracting, Oregon, Washington, and Alaska, Humana
Rhonda Mims
Executive Vice President, Chief Public Affairs and Risk Officer, AmeriHealth Caritas
Susan Mani
MD, Associate VP Population Health Strategy, Humana
Amy Compton-Phillips, MD
EVP, Chief Medical Officer, CVS Health
The Blue Cross Blue Shield Association has named five senior leaders to roles spanning technology, policy, operations and communications. 1. Mouli Venkatesan, chief information and technology officer. Mr. Venkatesan will oversee BCBSA’s IT infrastructure, technology modernization and AI deployment. He…
CommonSpirit Health’s Tennessee and Georgia facilities (formerly CHI Memorial), went out of network with Cigna Healthcare on Feb. 1. The network split affects individuals covered by Cigna’s commercial Open Access Plus PPO and its narrower-network Local Plus plan. The affected…
Hospitals focus heavily on denials — but denials are only part of the problem. Across the U.S., hospitals are losing millions each year to incomplete or inconsistent documentation that understates the true complexity of care delivered. Beyond visible denials lies…
Presented by:
Oakland, Calif.-based Kaiser Permanente and Reno, Nev.-based Renown Health have finalized a joint venture to launch a new outpatient care delivery system and co-own a health plan in northern Nevada. Five things to know: 1. Hometown Health, the health plan…