SCAN Health Plan has emerged as a major Medicare Advantage partner for retailers, with Walmart now partaking in a co-branded plan. The health insurer and retailer are launching the plan in two states, according to a Sept. 16 SCAN news…
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Healthcare navigation company Quantum Health named Susan Mani, MD, chief medical officer. Dr. Mani joins the company from Humana where she served as AVP of clinical strategy and operations. She previously served as AVP of population health strategy for the…
Health system leaders face relentless pressure to deliver capital cost savings, eliminate equipment redundancy, and repeatedly defend replacement cycles. Yet they must often confront these challenges with incomplete data, siloed systems, and aging spreadsheet-based workflows. The result: purchasing decisions driven…
Oct 20, 2026 1:00 PM - 2:00 PM CDT
Presented by:
Presenters:
- Kelley Jacobsen, Senior Vice President, Supply Chain & Shared Services, Trimedx
- David Stevens, Vice President & GM, Clinical Asset Management, Trimedx
Humana and UnitedHealthcare received a combined total of $177.8 million in Medicare Advantage overpayments tied to coding that was not supported by medical records, the HHS Office of Inspector General said in separate audit reports published Sept. 15. The OIG’s…
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Adventist HealthCare, based in Gaithersburg, Md., seeks a vice president of revenue cycle…
CMS’ interoperability rule will require many insurers to have application programming interface capabilities by Jan. 1, 2027. The clock is ticking, but some health plans are ahead of the curve. CMS is seeking patient access, provider access, provider directory, payer-to-payer…
ACA insurers requested a median rate increase of 15% for 2027, according to a Peterson-KFF Health System Tracker analysis. However, some states are pushing back — while others are abiding by those requests — as they finalize increases. The set…
CMS will add four condition tracks to its Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model starting in spring 2027, the agency said in a Sept. 15 news release. Four things to know: 1. The expansion adds heart failure,…
Medicare Advantage now covers more than 51% of eligible beneficiaries, but for a growing number of health systems, participating in the program has become a lose-lose proposition: stay in and absorb mounting losses, or exit and hand competitors an enrollment…
Healthcare CFOs’ tenures last an average of 3.7 years, according to a September report from Crist|Kolder Associates. Here’s how CFO tenure stacks up at the country’s largest health insurers: