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1. Clover beats CMS in Medicare Advantage star ratings lawsuit Full story
2. Aetna to launch ‘on demand’ virtual mental health services in 2027 Full story
3. BCBS Massachusetts and Highmark leaders share what separates clinical strategies that deliver from those that stall here.
4. UnitedHealthcare to scale back pediatric prior auth requirements Full story
5. AmeriHealth Caritas sued by pharmacies over alleged hidden fees Full story
6. Payment integrity is moving upstream. See how plans balance margin and provider trust here.
7. Elevance’s chief growth officer for Carelon departs Full story
8. Highmark posts $216M operating income in Q1, driven by health plan turnaround Full story
9. Ascendiun CEO joins CMS’ Healthcare Advisory Committee Full story
10. Wisconsin health plan CEO to retire after 20 years Full story
11. 10 states where residents spend most, least on healthcare Full story
12. Preference-sensitive surgery is quietly driving surgical spend — and most plans aren’t catching it. See why here.
Becker’s Learning Opportunities
13. Where does cancer support break down for your members? Find the gaps — and fixes — here.
14. CMS-0057-F is accelerating change. How payers can build interoperable prior authorization workflows now here.
15. Why prior authorization breaks down — and what real-time AI is doing about it 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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