CEO Pooja Ika launched eternalHealth at just 24 years old in 2020, focusing on Medicare Advantage. But, a few years in, she says some health plans and their leaders are distracted — and she was, too. “When you ask me…
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Today, nearly half of Americans struggle to afford basic healthcare, and patients wait an average of 38 days to see a doctor. At the same time, 80% of at-risk members remain unreachable. These barriers are unsustainable for members and health plans alike. While value-based care…
Blue Cross and Blue Shield of Alabama and the Medical Association of the State of Alabama agreed upon changes to prior authorization, according to a Nov. 4 news release. Over the past year, the insurer and the physician group collaborated…
AI is reshaping behavioral health — but the goal isn’t automation, it’s augmentation: using technology to enhance, not replace, human care. This session explores how ethical AI can make care more personal and scalable. Grounded in standards developed by top…
Dec 10, 2025 12:00 PM - 1:00 PM America/Chicago
Presented by:
Presenters
Brad Smith Ph.D.
Senior Data Scientist, RethinkFirst
A pair of U.S. senators sent a letter to CMS Administrator Mehmet Oz, MD, seeking answers for what they described as a “rushed launch” of the Medicare Advantage provider-directory tool. Sens. Jeff Merkley, D-Ore., and Ron Wyden, D-Ore., said in…
Humana documented a net income of $195 million for the third quarter of 2025, down from $480 million during the same period last year, according to a Nov. 5 earnings release. The company reported $32.65 billion in total revenue, an…
Blue Cross and Blue Shield of Massachusetts has lost its legal challenge against CMS over the methodology used to calculate its 2025 Medicare Advantage star ratings. In a Nov. 3 ruling from the U.S. District Court for the District of…
UnitedHealth’s Optum is laying off 572 workers throughout New Jersey, with some cuts effective as early as Feb. 2, 2026, according to four October WARN notices. Optum Care will let 370 people go, but Optum Medical Care, Optum Services and…
Fort Lauderdale, Fla.-based Broward Health and Hollywood, Fla.-based Memorial Healthcare System are partnering to offer Broward County residents a new health insurance option on the ACA Marketplace for 2026, The South Florida Sun Sentinel reported Nov. 1. The insurer, called…
Brewer, Maine-based Northern Light Health and Anthem Blue Cross Blue Shield failed to establish a new contract extending coverage by their Oct. 31 deadline, both organizations confirmed to Becker’s. “We continue to work closely with Anthem to conclude negotiations as…