Cost Plus Drugs co-founder Mark Cuban and Humana CEO Jim Rechtin said their companies are working together, Forbes reported Dec. 4. “We’re talking to CenterWell,” Mr. Cuban said during the Forbes Healthcare Summit. “I would say we are treating the…
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Having a sense of purpose promotes health engagement, according to research published Dec. 4 by The Cigna Group. But fewer than one-third of adults have it. In collaboration with YouGov, Cigna’s “Vitality in America” report fielded responses from 5,000 Americans.…
Two New York state lawmakers are pressing the state’s health department to investigate UnitedHealth Group’s physician practice arm, Optum, according to a Dec. 3 report from Mid Hudson News. New York state Sen. Peter Harckham and Assemblyman Matt Slater called…
Traditional consultants deliver reports and recommendations — then leave hospitals to figure out the rest. It’s a model that’s falling short in today’s healthcare environment. That’s why hospitals are shifting toward co-managed partnerships. These models embed clinical and operational leaders…
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Presented by:
Presenters:
- John Birkmeyer, MD, President, Medical Group, Sound Physicians
- Roberta Luskin-Hawk, MD, Regional President, Sound Physicians
- Melissa Buchner-Mehling, MD, CHCQM, CPHYADV, FABQAURP, Associate Chief Medical Officer, Sound Physicians
The One Big Beautiful Bill Act (OBBBA) will slash Medicaid spending by $900 billion over the next decade with an estimated 7.5 million people losing coverage. These shifts will hit health systems hard, especially those serving Medicaid expansion and undocumented…
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The U.S. Government Accountability Office found significant fraud risk in the ACA application process, according to a Dec. 3 agency report. Auditors applied for coverage under fictitious identities to test marketplace enrollment controls. The marketplace approved coverage for the four…
Aetna is bundling pharmacy prescriptions and medical procedures into a single clinical review, according to a Dec. 4 news release. Providers previously had to submit two prior authorizations, but, as of November, providers only have to file one medical review,…
The One Big Beautiful Bill Act is poised to slash Medicaid revenue by $25 billion annually, a 70% drop in operating margin for the average hospital. With redeterminations moving to every 6 months, patients are losing coverage. Payers are escalating…
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The Trump administration introduced plans to lower obesity drug costs for Medicaid and Medicare, but commercial insurance coverage of GLP-1s remains a concern. “There is some speculation that this initiative will help create downward pressure for drug manufacturers to lower…
New Jersey has finalized rules requiring state-regulated insurers to cap out-of-pocket costs on insulin, asthma inhalers and epinephrine auto-injectors. The state published the final regulations Dec. 1, implementing legislation Gov. Phil Murphy signed that made New Jersey the second state…