Insurers have until Sept. 30 to issue ACA Medical Loss Ratio rebates for 2024. The Medical Loss Ratio mandates insurance companies spend at least 80% or 85% of their premium dollars on medical care, not administrative expenses or profits. If…
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Dan Kueter is the CEO of UnitedHealthcare’s employer and individual insurance business, an $80 billion division and the nation’s largest company that offers health coverage to employers nationwide. Mr. Kueter has been with the company since 2001 and has served…
PacificSource will no longer serve 100,000 Medicaid members in Lane County — which includes Eugene, Ore. — after failing to reach an agreement with the Oregon Health Authority, PacificSource Vice President of Medicaid Programs Erin Fair Taylor told Becker’s. “We…
Every new AI capability promises value, but without interoperability, insights stall at the edge — in imaging, in care management, in notes. CIOs and informatics leaders need a blueprint to move the right information to the right system at the…
Oct 29, 2025 11:00 AM - 12:00 PM CDT
Presented by:
Presenters:
- Dr Rowland Illing, Global Chief Medical Officer and Director, Healthcare and Life Sciences at Amazon Web Services (AWS) / Visiting Professor of Informatics and Imaging at the University of Oxford
- Tom Valent, Chief Business Officer, Aidoc
- Shaun Miller, MD, MBA, Chief Health Information Officer Cedars-Sinai
Aging in place, medical care access and economic insecurity are the top three social factors that affect aging experience, according to Alignment Health’s “2025 Social Threats to Aging Well in America Survey.” Over 2,200 adults age 65 or older completed…
In one of the largest shifts in the Medicare Advantage landscape in recent years, Health Care Service Corporation has nearly quadrupled its Medicare Advantage membership after closing on a $3.3 billion acquisition of Cigna’s Medicare business in March. The deal,…
Payers are prioritizing tech investments but the real challenge is balance. Reducing friction for providers while maintaining evidence-based decisions remains a critical tension. AI is now central to solving this, especially in replacing slow, manual reviews that delay care, drain…
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Presented by:
Presenters:
- Tony Oliva, DO, Chief Medical Officer, MCG Health
- Kristy Stayer, Sr. Product Owner, MCG Health
Higher utilization contributed to Medicare Advantage’s $5.7 billion underwriting loss in 2024, a marked reversal from serving as a source of earnings in the last five years, said an AM Best news release covering a Sept. 23 report. “Changes to…
Pricing operations in healthcare today are grappling with issues reminiscent of the early days of electronic medical records (EMRs). In the 1990s and early 2000s, EMR systems were fragmented across departments—emergency rooms, radiology, labs—each functioning in isolation. That same siloed…
Payers are using AI to automate and deny claims faster than ever. Meanwhile, only 8% of providers use AI in denials management. This whitepaper breaks down how leading health systems including Banner Health and Houston Methodist are closing the gap…
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