The Latest - Page 30 of 1587 - Becker's Payer Issues

Beyond staffing: Building a resilient workforce for specialized pediatric care

Children are 23 percent of the U.S. population, yet pediatrics drew just 8.1 percent of matched medical residents in 2025, down from 8.8 percent in 2021, according to the Children’s Hospital Association. For children’s hospitals, that shortfall becomes a daily…

Nov 11, 2026 11:00 AM - 12:00 PM CST

Presented by:

Presenters:

Kristi McGowin, CNO and VP of Patient Care Services, Children's Hospital of The King's Daughters (CHKD)
Desiree Ritter, CNO, Children’s Hospital of Los Angelas (CHLA)
Crystle Illa, Director of Talent Acquisition, Children’s Minnesota
Enderson Miranda, VP Strategic Accounts, AMN Healthcare
Mike Meekins, Senior Vice President Operations, Phoenix Children’s

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HCA hospitals escalate payment fight with insurers

Hospitals affiliated with Nashville, Tenn.-based HCA Healthcare have sued multiple insurers over alleged claim denials and reimbursement issues in 2025 and 2026. These cases contribute to a broader landscape of legal battles between providers and insurers. Most recently, seven hospitals…

Strengthening financial resilience: how AI improves revenue integrity and quality metrics at the source

Medicaid funding is tightening and uncompensated care is climbing. As those pressures mount, health systems can’t afford for the clinical and financial value of care they provide to go unrecognized. Much of that gap is structural. Targeted and retrospective reviews…

Dec 11, 2026 1:00 PM - 2:00 PM CST

Presented by:

Presenters:

Emily Goertz, Associate Vice President and Chief Revenue Officer, UK HealthCare
Gary Basra, Chief Technology Officer, Accuity

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7 HCA-affiliated hospitals sue Anthem BCBS Georgia over reimbursement

Seven hospitals affiliated with Nashville, Tenn.-based HCA Healthcare filed a lawsuit Oct. 5 against Anthem Blue Cross and Blue Shield in Georgia, part of Elevance Health, alleging denied or underpaid claims, according to court records reviewed by Becker’s. Corpus Christi…

Fitch: Human review in AI prior authorization denials likely here to stay

Health insurers are using AI to speed up prior authorization, but Fitch Ratings expects regulators to keep requiring humans in the loop when care is denied, and that will limit how much efficiency payers can gain. The outlook comes from…

Health plan enrollment drops 2.8% as individual market, Medicaid shrink

Health insurers’ membership declined 2.8% year-over-year to about 312.5 million people in the first half of 2026, as losses in the individual market and Medicaid outpaced gains in Medicare Advantage and employer-based plans. The figures come from a Sept. 29…

Keeping claims out of IDR: How payers are containing No Surprises Act costs

The No Surprises Act has delivered on one of its central promises: fewer surprise medical bills. A survey from AHIP and the Blue Cross Blue Shield Association found that the NSA protected patients from nearly 20 million potential surprise bills…

What a revenue cycle operating model looks like when it actually scales

Picture a revenue cycle where work is standardized before automation is applied. Repeatable, bounded tasks are automated within defined guardrails. Exceptions route to the people qualified to handle them rather than through a chain of escalations. Accountability is built into…

Nov 19, 2026 11:00 AM - 12:00 PM CST

Presented by:

Presenters:

Navaneeth Nair, Chief Product Officer, Infinx Healthcare
Stuart Newsome, CPCO, Vice President, RCM Insights, Infinx Healthcare

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GLP-1 spending rose 84% in 1 year at BCBS Massachusetts: Study

Higher use of medical services and prescription drugs, rather than rising inflation-adjusted prices, drove a recent uptick in commercial spending at Blue Cross Blue Shield of Massachusetts, according to a study published Oct. 5 in Health Affairs. The analysis was…

Atrium, NC State Health Plan at odds over member affordability program

Charlotte, N.C.-based Atrium Health launched a program to lower out-of-pocket costs for North Carolina State Health Plan members who use its physicians and hospitals, but State Treasurer Brad Briner warned the program could bankrupt the plan, North Carolina Health News…