Two companies earned the “best overall” recognition in U.S. News & World Report‘s 2026 ratings for Medicare Part D prescription drug coverage. Both were among the top four last year. This year’s scores rely on CMS star ratings, as well…
The Latest
Three companies secured the “best overall” title in the U.S. News & World Report 2026 ratings for Medicare Advantage plans. Two made the cut last year, as well. This year’s scores rely on CMS star ratings, as well as 37…
CMS Administrator Mehmet Oz, MD, discussed some of the biggest issues facing the Medicare Advantage program at an Oct. 15 industry conference. During his first six months on the job, CMS has already overseen policy moves to streamline prior authorization…
Vermont, Utah and Minnesota topped the Commonwealth Fund’s Medicare performance scorecard in 2025, whereas Kentucky, Mississippi and Louisiana struggled the most. The healthcare research foundation evaluated states on criteria spanning four domains: access to care, quality of care, costs and…
Commercial insurance prices were 78% higher in hospital outpatient settings compared with ambulatory surgical centers in 2024, according to a Health Affairs study published in October. The analysis, led by researchers at Brown University, examined 2024 pricing data for UnitedHealthcare,…
OR inefficiency doesn’t always look like downtime. It often hides in missed opportunities, such as unused blocks, delayed scheduling and reactive processes. At Inova, released OR time meant lost revenue, surgeon frustration and underused resources. Emails and spreadsheets weren’t keeping…
Nov 13, 2025 11:00 AM - 12:00 PM CST
Presented by:
Presenters:
- Kelly Connolly, MHSA, PMP, Senior Director of the Surgery Service Line, Inova
- Jane Yang, MHA, Director of Operations, Perioperative Services Surgery Service Line Administration, Inova
- Caity Butler, MSN, RN, CNOR, Manager of Centralized Scheduling, Inova
- Thomas Brehmer, Client Outcomes Manager, LeanTaaS
A federal judge rejected Blue Cross Blue Shield of Rhode Island’s motion to dismiss a lawsuit over coverage of wilderness therapy, according to Oct. 14 court documents. Wilderness therapy is a mental health intervention that involves immersing young people in…
AI is flooding healthcare, but not all of it improves outcomes or deserves trust. For payer leaders overseeing utilization, case management and other clinical operations, the question isn’t whether to adopt AI — it’s how to evaluate the right kind.…
On Demand
Presented by:
Presenter:
- Tony Oliva, DO, MMM, FACPE, Chief Medical Officer, MCG Health
Hospitals are under relentless pressure to do more with less. In response, forward-looking leaders are using artificial intelligence, automation and predictive analytics to transform revenue cycle management now. From faster prior auth to fewer denied claims and improved patient engagement,…
Nov 19, 2025 1:00 PM - 2:00 PM CST
Presented by:
Presenters:
- Abhijith Godbole, Associate Vice President, Digital Solutions, Sutherland Global
- Abhishek AK, AVP, Healthcare, Everest
Following the kickoff of Medicare open enrollment on Oct. 15, The Washington Post discovered inconsistencies in the Medicare Plan Finder, such as duplicative addresses and contradictory information regarding providers’ network status. After the Post reported the issues to CMS, an…