Humana has reintroduced a lawsuit challenging its Medicare Advantage star ratings. On July 18, U.S. District Judge Reed O’Connor dismissed the case without prejudice. Mr. O’Connor ruled that Humana had not exhausted all of its administrative appeal options when it…
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Massachusetts has rejected ACA rate proposals for 2026 from BCBS Massachusetts and WellSense Health Plan. WellSense is the insurance arm of Boston Medical Center, which requested a 16.2% rate increase for the individual and small employer market next year. BCBS…
Delayed reimbursements, rising denials and under-resourced revenue cycle teams are putting hospital margins at risk. This report shares insights from 115 finance and RCM leaders on how health systems are upgrading workflows with automation, hybrid staffing models and strategic partnerships…
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Disconnected tech, workforce shortages, and documentation gaps undermine revenue cycle performance and drain health system margins. But leading systems are finding relief and results in a reimagined mid-rev cycle powered by AI. Join RCM insiders as they break down how…
Aug 20, 2025 11:00 AM - 12:00 PM CDT
Presented by:
Presenters:
- Tanai Lobban, product owner, Solventum
- Nichole DeLong, coding solutions advisor, Solventum.
- Josh Amrhein, business manager, revenue integrity, Solventum
- Julie Salomon, CDI business director, Solventum
Infusion volumes at Baptist MD Anderson Cancer Center have more than doubled since 2019, topping 39,000 visits last year. Growth of that scale can swamp even seasoned nursing teams, elongate patient wait times and expose hidden scheduling gaps. Instead…
Sep 4, 2025 1:00 PM - 2:00 PM CDT
Presented by:
Presenters:
- LeeAnn Mengel, RN, MBA, CMPE, FACHE, Vice President and Administrator, Baptist MD Anderson Cancer Center, Baptist Health
- Christi Urman, Senior Account Manager, iQueue for Infusion Centers, LeanTaaS
EHRs have evolved far beyond simple digital archives. Today, forward-thinking health systems are moving EHRs to the cloud to unlock faster performance, protect critical data and drive real innovation. This report summarizes perspectives from CIOs and chief medical and nursing…
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Oscar Health is expecting to operate at a loss in 2025 as costs climb in the individual market. The company reported preliminary results for the second quarter of 2025 on July 22, expecting a loss from operations of $200 million…
Humana is accelerating its efforts to reform the prior authorization process through a series of new policies, following the broader insurance industry’s recent pledge to reduce and streamline prior auth requirements. By January 1, 2026, Humana will eliminate one-third of…
The Medicare Part D market is facing an “uncertain future,” according to an analysis from KFF published July 16. The future of the Part D market depends on whether CMS extends the Part D premium stabilization program put in place…
Many health plans still rely on basic segmentation and static messages — leaving members feeling like numbers. But the stakes are rising fast: With heightened expectations and fierce competition, payers must deliver timely, relevant experiences to keep members engaged. Join…
Aug 27, 2025 1:00 PM - 2:00 PM CDT
Presented by:
Presenters:
- Robert Connely, Pega Systems – Healthcare Industry Market Leader at Pega Systems
- Lori Logan, President & CEO, NASCO
- Tina Galloway, Vice President, Enterprise Client Executive, Optum
- Mike Gerrish, From Member Frustration to Member Loyalty: And the role of AI