Clever Care Health Plan CEO Karen Walker Johnson, BSN, thinks her company’s edge is one that bigger insurers might have trouble replicating. That edge is Clever Care’s focus on offering “culturally sensitive Medicare options,” and it is baked into the…
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Academic health systems are entering a defining decade. Many are expanding rapidly through mergers, affiliations and new service lines. But with scale comes risk: fragmentation, mission drift and uneven progress on access and equity. This whitepaper features insights from 11…
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A Colorado law equalizing behavioral and physical health in insurance coverage went into effect Jan. 1, preventing carriers in the state from limiting the “medically necessary treatment” of behavioral, mental health and substance use disorders. The law was passed in…
Orthopedic and musculoskeletal (MSK) practices are entering a new era of revenue cycle pressure — one defined by coding complexity, chronic staffing shortages, and rapidly shifting payer requirements. These forces are converging to create a perfect storm: rising denial rates,…
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Priority Health is now the sole governing member of Group Health Cooperative of Eau Claire, a community-based health plan in Wisconsin serving more than 61,000 members. The transaction was first announced in July and was completed Jan. 1. The move…
GLP-1s and high-cost claims get the attention, but the real drain on health plans? Chronic disease driven by delayed intervention and low preventive care use. Join finance and HR leaders from CommonSpirit and MedStar to explore a prevention-first model proven…
Feb 4, 2026 12:00 PM - 1:00 PM America/Chicago
Presented by:
Presenters
Scott Charles
Chief Financial Officer, Personify
Shelly Schorer, FHFMA, MBA
California CFO, CommonSpirit Health
Michael Sloan
VP of Human Resources / CHRO, CommonSpirit Health
From $1 trillion in Medicaid cuts courtesy of the One Big Beautiful Bill Act to workforce shortages, Medicaid home- and community-based services are under pressure. KFF evaluated payment rates, provider closures and staffing issues through a 2025 survey. All states,…
New York Gov. Kathy Hochul blamed a 38% average spike in health insurance premiums for state residents on the Dec. 31 expiration of ACA enhanced premium tax credits. The average monthly increase for a New York couple is $228. Out…
CMS has lifted its enrollment freeze on Gold Kidney of Florida after state regulators restored the insurer’s ability to accept new members. The agency released its intermediate sanction on Gold Kidney’s Medicare prescription drug plan, effective Dec. 15, 2025. The…
Optum has begun reviewing Minnesota Medicaid claims as part of an enhanced prepayment audit, state officials said, as the state grapples with a widening fraud crisis in its public assistance programs. On Jan. 5, Minnesota Gov. Tim Walz said he…