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The case that falls off your schedule the morning of surgery was lost weeks earlier

A patient who isn’t ready on the morning of surgery becomes a cancellation, a no-show or a case that starts late. By then, there are no easy choices left. The cost shows up in places a cancellation report doesn’t track.…

Oct 9, 2026 12:00 PM - 1:00 PM CDT

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Presenters:

Robert Westergan, MD, Orthopedic Surgeon, Medical Director, Hinge Health
Stephen Lance, Provider Network Development, Hinge Health

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Beyond the care gap report: What HEDIS performance really takes

Most health plans can already see their care gaps. The harder part is reaching the members behind those gaps and helping them follow through on the screenings, visits and preventive care that quality measures depend on. That challenge runs through…

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Plan switches for dually eligible MA members increasingly common

Switching between Medicare Advantage plans has become more popular in recent years, particularly for enrollees who are dually eligible for Medicaid, according to a study published Sept. 9 in the American Journal of Managed Care. The research relied on administrative…

‘We’re here for the long term’: Health Alliance Plan doubles down on Medicare Advantage as others retreat

As insurers and provider-sponsored health plans reassess their exposure to Medicare Advantage, Detroit-based Henry Ford Health is moving in the opposite direction. Medicare Advantage enrollment at Health Alliance Plan by Henry Ford Health surged 45.8% year over year to 132,566…

Trump pledges $500 checks to 1 million people for ACA 'overcharges'

The Trump administration says it will mail $500 checks to nearly one million Americans in 30 states to refund what it called “overcharges” from ACA exchange fees collected under the Biden administration. On Sept. 10, the White House said insurers…

Dignity sues Medi-Cal plan, claiming $30M in unpaid bills

San Francisco-based Dignity Health and Dignity Community Care filed a lawsuit against Gold Coast Health Plan Aug. 24, alleging more than $30 million in unpaid bills. The Dignity entities, under Chicago-based CommonSpirit Health, include St. John’s hospitals in Ventura County,…

UnitedHealth CFO says 'tough decisions' in Medicare Advantage are paying off

UnitedHealth Group says its Medicare Advantage business is outperforming initial margin targets for 2026, crediting deliberate financial recovery moves that meant fewer members this year. Speaking at a Wells Fargo conference Sept. 9, CFO Wayne DeVeydt said the company “really…

Former CVS exec wins Democratic nomination for Rhode Island governor over incumbent

The former president of CVS Pharmacy, Helena Buonanno Foulkes, defeated incumbent Daniel McKee in Rhode Island’s Democratic primary for governor Sept. 9. According to voting data from the Associated Press, 62.4% of counted votes went to Ms. Buonanno Foulkes, whereas…

12 recent payer fines from states

Payers have faced state penalties in 2026 for slow reimbursements, mishandled member complaints, and mental health parity violations. Fines in 2025 are here. Payers fined by states in 2026: 1. Blue Shield of California was fined $800,000 by California over…

Prime Therapeutics taps CFO from Walgreens

Prime Therapeutics has named Manmohan Mahajan as chief financial officer. Mr. Mahajan most recently served as executive vice president and global CFO at Walgreens Boots Alliance, according to a Sept. 10 news release. Prime is collectively owned by 19 Blue…