The Latest - Page 285 of 1588 - Becker's Payer Issues

The Ambient AI Conversation: Predictions for 2026

For ambient AI, 2024 was the year when platforms partnered with health systems to build together and prove the concept, and 2025 was the year of scale and measuring impact. What incredible breakthroughs are in store for healthcare AI in…

Dec 15, 2025 12:00 PM - 1:00 PM CST

Presented by:

Presenters:

Jeffrey Flaks, President and Chief Executive Officer, Hartford HealthCare
Terri Couts, SVP, Chief Information and Digital Officer, Sharp Healthcare
Chris Burnett, AVP Clinical Innovation & Investment, CVS Health
Guru Sundar, VP of Marketing, Abridge

Register

The state of workforce compliance in 2025: 5 key takeaways for healthcare leadership

The healthcare workforce crisis extends beyond staffing, exposing critical compliance blind spots with tangible consequences like fines, regulatory actions, reputational damage, and compromised patient safety. Are your leaders truly confident in your organization’s compliance? Download this new report, based on…

Presented by:

Download

Bipartisan bill aims to expand lung cancer screening by cutting through 'insurance red tape'

U.S. Reps. Kathy Castor, D-Fla., Brian Fitzpatrick, R-Pa., and Debbie Wasserman Schultz, D-Fla., have reintroduced a bill to widen access to lung cancer screenings, according to a Nov. 20 news release. The bill prevents Medicaid, traditional Medicare, Medicare Advantage, and…

Why health systems can’t afford to overlook urgent care

Urgent care has moved from a convenience play to a competitive lever. For health systems navigating declining reimbursement, shifting consumer expectations and overcrowded EDs, a strategic urgent care footprint can accelerate growth and enhance access while protecting and growing market…

Presented by:

Download

Eli Lilly to launch direct-to-employer GLP-1 model

Eli Lilly plans to launch a direct-to-employer model for its GLP-1 medications in early 2026 in a move aimed at giving companies more flexibility in designing obesity management benefits for their employees. The model will include three components: flexible benefit…

Judge approves Aetna's $3.4M settlement over proton beam therapy coverage

A federal court in Florida has approved a $3.4 million class action settlement resolving claims that Aetna improperly denied coverage for proton beam radiation therapy to treat cancer. The lawsuit was filed in 2020 by a Florida resident whose request…

Independent Health, MVP bet on PBM as bigger rivals face regulatory crackdown

Independent Health is joining MVP Health Care, another nonprofit insurer based in New York. Sharing assets is one reason for the member substitution agreement, but there is another opportunity for the organizations. Pharmacy Benefit Dimensions is a subsidiary of Independent…

Oregon flags 3 payers over 'unreasonable' surge in healthcare costs

Oregon health regulators have flagged three payers for “unreasonably high healthcare cost growth in 2023.” In an October report, the Oregon Health Authority said that Moda Health’s Medicare Advantage plans increased costs by 15.4%, PacificSource’s commercial plans grew 7.3%, and…

Chart reviews boost Medicare Advantage payments: 4 things to know

Insurers carry out chart reviews to verify alignment between medical records and information submitted by providers. While these reviews can help payers understand a beneficiary’s needs and increase payments to accommodate anticipated costs, they could also be used inappropriately. “Chart…

Gold Coast Health Plan names COO

Gold Coast Health Plan appointed Suma Simcoe as COO, effective Oct. 15, according to an Oct. 30 news release. Ms. Simcoe joined GCHP from L.A. Care Health Plan and was previously at Molina Healthcare. She has a record of launching…