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1. UnitedHealth CFO says ‘tough decisions’ in Medicare Advantage are paying off Full story
2. Blue Shield of California fined $800K over delayed member complaint resolution Full story
3. As AI becomes part of the front door to care, payers face new questions around accountability and oversight. Learn more.
4. Aetna’s chief medical officer for Medicare departs Full story
5. Former CVS exec wins Democratic primary in Rhode Island gubernatorial race Full story
6. ‘Different opinions and perspectives from leaders in this space.’ – Allison Soto, Senior Manager, Aetna. 500+ payer executives are gathering Nov. 2-3 in Chicago at Becker’s Fall Payer Issues Roundtable. Apply to attend as a reviewer here.
7. 17 states could face Medicaid spending cuts of 10% to 25% under HR 1: Study Full story
8. What’s next for Capital Blue Cross after expanding behavioral health resources Full story
9. Prime Therapeutics taps CFO from Walgreens Full story
10. Anthem moves to cover surgical mesh for breast reconstruction Full story
11. Two Ascension hospitals face possible Medicare termination after pharmacy error Full story
12. Governed AI agents can raise audit hit rates at scale. Learn how here.
Becker’s Learning Opportunities
13. Highmark’s sales enablement VP on turning employer data into stronger renewals here.
14. Coordination alone won’t fix cancer costs. Evry Health’s CMO on what will here.
15. Risk adjustment without the annual scramble: See why perspectives from informatics and actuarial teams help — in this webinar.
16. Becker’s September webinar lineup: hospital AI, nonopioid pain care and analytics governance. See the sessions here.
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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