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1. Centene boosts guidance amid $1.1B Q2 profit, ACA membership drop Full story
2. 4 more Medicare Advantage contracts get 5 stars in revised ratings Full story
3. What makes a clinical guideline trustworthy—and why does it matter even more in the age of AI? Read more here.
4. Medicare Advantage enrollment share to reach 57% by 2036: CBO Full story
5. 5 health system vs. payer lawsuits to watch Full story
6. GLP-1s are reshaping pharmacy economics for every health plan, ICHRA is changing the employer-sponsored market, and direct contracting is shifting the network model. All three are on the agenda Nov. 2-3 in Chicago. Apply to attend Becker’s Fall Payer Issues Roundtable as a reviewer here.
7. CVS looks to dismiss hospitals’ 340B lawsuits Full story
8. 8 things to know about healthcare spending trends Full story
9. 10 best states for healthcare: US News Full story
10. 1.2 million adults in states without expanded Medicaid fall into coverage gap: KFF Full story
11. Employer coverage subsidies to reach $840B by 2036: CBO Full story
12. Claims processing and care coordination weren’t built for autonomous AI. See the fix, here.
Becker’s Learning Opportunities
13. When the NEMT audit arrives, your health plan is the responsible party. Prepare here.
14. New study uncovers what separates AI leaders and laggards. Get the payer-centric data here.
15. FHIR readiness isn’t enough. Build a smarter prior authorization strategy beyond compliance here.
16. Becker’s resources don’t stop here — explore more webinars and whitepapers.
Apply to attend complimentary as a guest reviewer here! Opportunity exclusive to those directly employed by a payer, payvider, accountable care organization, or clinically integrated network.
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