The Latest - Page 356 of 1590 - Becker's Payer Issues

From data to dollars: How to optimize reimbursement strategy

Margin erosion, payer rate compression and regulatory mandates are squeezing healthcare revenue. For many systems, reimbursement strategies remain reactive, leaving millions on the table. Without a data-driven approach, organizations risk falling behind in payer negotiations and missing opportunities that standalone…

Sep 18, 2025 1:00 PM - 2:00 PM CDT

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Presenters:

Michael Faulkenberry, Director, Data & Intelligence Solutions Strata Decision Technology
Josh Wiggins, Senior Director of Product Management-Decision Support Strata Decision Technology

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Metrics That Matter: Moving the Needle on Flow, Quality, and Financials

Hospitals face an overwhelming number of performance metrics, making it challenging to know where to focus. In this session, you’ll learn how health system leaders cut through the noise prioritizing the right metrics and using advanced analytics, interdisciplinary huddles, and…

Sep 24, 2025 11:00 AM - 12:00 PM CDT

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Presenters:

Tony Briningstool, MD, FACEP, Chief Executive Officer, Emergency Medicine
Mihir Patel, MD, MBA, CPE, Chief Executive Officer, Hospital Medicine

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All Anthem plans in California achieve NCQA Health Equity accreditation

Anthem Blue Cross’ commercial and ACA health plans in California have been awarded Health Equity Accreditation from the National Committee for Quality Assurance through July 28, 2028. Anthem’s Medi-Cal plan previously earned the NCQA’s Health Equity and Health Equity Plus…

West Virginia system plans ‘substantial’ Medicare Advantage expansion

Peak Health is planning its largest expansion to date in the Medicare Advantage market, more than doubling its potential footprint in its home state and moving into Pennsylvania for the first time. “We’re looking to expand substantially. We will be…

BCBS Massachusetts posts $130M loss in Q2

Blue Cross and Blue Shield of Massachusetts reported a net loss of $129.7 million on revenue of $2.6 billion (-4.9% net margin) in the second quarter. Year-to-date, the company has reported a net loss of $92.6 million on revenue of…

Georgia fines insurers $20M over mental health parity violations

Georgia regulators are fining health insurers more than $20 million for failing to comply with state and federal mental health parity laws. Insurance Commissioner John King said Aug. 15 that the penalties follow examinations that uncovered more than 6,000 violations…

Healthcare operations under pressure: 10 must-reads on what top systems are doing now

Siloed systems. Burned-out teams. Delays in care delivery. Today’s operational challenges are compromising performance across the healthcare enterprise, and the cost of inaction is rising. Operations are now a systemwide priority — the engine driving results across clinical, IT, HR…

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From automation to transformation: AI’s role in payment integrity

With recent breakthroughs in artificial intelligence (AI), health plans are at a precipice of change. At Optum, we’re leveraging emerging technologies to drive payment accuracy—but it’s just the starting point. We believe AI has the potential to completely transform the…

Providence hospitals allege Kaiser Health Plan underpaid millions for emergency care

Providence hospitals across California are the latest to sue Kaiser Permanente over allegations that the organization’s health plan has underpaid for emergency and post-stabilization care provided to Kaiser members. The Providence complaint reviewed by Becker’s was filed April 11 in…

Adoption, Scale, and Impact of Ambient AI: Data and Insights From 150+ Enterprise Deployments

Generative AI is changing healthcare at an accelerating pace. Yet, less than half of health systems have moved beyond the ideation stage of AI projects. That is not the case for the Abridge ambient AI platform’s 150+ enterprise customers. Abridge…

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