Evry Health CEO and co-founder Chris Gay thinks the health insurance industry could eliminate prior authorizations entirely, but only if providers meet insurers halfway. On the Becker’s Payer Issues podcast, he spoke about the technology and business model problems fueling…
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Providers win about 80% of “No Surprises Act” cases that reach arbitration, according to Elevance Health Public Policy Institute research published Dec. 10 in Inquiry: The Journal of Health Care Organization, Provision and Financing. Researchers reviewed Elevance Health’s 2023 dispute…
Commercial health insurance markets are continuing to become more concentrated, according to the AMA’s 2025 “Competition in health insurance” report published Dec. 16. The 24th annual report analyzed insurer market concentration across 384 metropolitan areas and all 50 states and…
The National Council of Insurance Legislators adopted the Prior Authorization Reform Model Act sponsored by a Mississippi state senator at the group’s annual meeting. “The model will protect the provider-patient relationship from unnecessary third-party interference, prevent programs from hindering the…
U.S. Democratic Sens. Patty Murray of Washington, Ron Wyden of Oregon and Kirsten Gillibrand of New York introduced a bill that would block the CMS Wasteful and Inappropriate Service Reduction model. The six-year WISeR pilot, set to kick off next…
At NMHS, virtual nursing is an enterprise-wide model serving a 400-bed flagship hospital and seven community hospitals. With virtual nurses completing 90% of discharges and 70% of admissions, NMHS has proven what’s possible when digital care is built for frontline…
Jan 28, 2026 12:00 PM - 1:00 PM America/Chicago
Presented by:
Presenters
Heather Wilf, MSN RN, CAVRN
Manager Virtual Care, North Mississippi Health Services
Marcia Murphy, MSN, RN, AGACNP-BC, ANP-BC, NE-BC, CCRN, CPHQ
Chief Clinical Operations Officer, Vitalchat
UnitedHealthcare reached a settlement with a cap of $6.75 million in a class-action lawsuit over coverage of proton beam therapy for cancer patients, according to a Dec. 12 court filing in the Massachusetts U.S. District Court. Proton beam therapy is…
California’s Department of Managed Health Care fined three Centene-owned health plans a total of $1.7 million over concerns about not meeting reporting rate standards for timely access of appointments. The department fined Health Net of California $1.2 million, Human Affairs…
Pittsburgh-based Highmark Health reported $24.6 billion in revenue, a $204 million operating loss, and a $69 million net loss in the first nine months of the year. Allegheny Health Network reported revenue of $4.2 billion during the period and an…
Humana’s insurance segment president, George Renaudin, will retire by the third quarter of 2026 following a nearly 30 year career at the company. He will serve as a strategic advisor to the company through at least the end of next…