The Latest - Page 106 of 1405 - Becker's Payer Issues

What drove Trinity Health’s 14% drop in preventable hospitalizations

Preventable hospitalizations are costing health systems millions, especially among Medicare and dual-eligible populations. Too often, traditional care models fall short when social determinants of health go unaddressed. Discover how Trinity Health’s social and clinical care integration improved patient outcomes, reduced…

Aug 27, 2025 12:00 PM - 1:00 PM America/Chicago

Presented by:

Presenters

Maureen Pike, MPH, MBA, RN

Director, Social & Clinical Care Integration | Trinity Health

Carla Nelson, MBA

Senior Director of Healthcare & Public Policy | Findhelp

Humana refiles Medicare Advantage ratings challenge

Humana has reintroduced a lawsuit challenging its Medicare Advantage star ratings. On July 18, U.S. District Judge Reed O’Connor dismissed the case without prejudice. Mr. O’Connor ruled that Humana had not exhausted all of its administrative appeal options when it…

Massachusetts rejects 2 payers' proposed ACA rate hikes

Massachusetts has rejected ACA rate proposals for 2026 from BCBS Massachusetts and WellSense Health Plan. WellSense is the insurance arm of Boston Medical Center, which requested a 16.2% rate increase for the individual and small employer market next year. BCBS…

RCM at a crossroads: How 100+ finance leaders are preparing for what’s next

Delayed reimbursements, rising denials and under-resourced revenue cycle teams are putting hospital margins at risk. This report shares insights from 115 finance and RCM leaders on how health systems are upgrading workflows with automation, hybrid staffing models and strategic partnerships…

Presented by:

The RCM overhaul: How AI is helping hospitals improve margins & reduce friction

Disconnected tech, workforce shortages, and documentation gaps undermine revenue cycle performance and drain health system margins. But leading systems are finding relief and results in a reimagined mid-rev cycle powered by AI. Join RCM insiders as they break down how…

Aug 20, 2025 11:00 AM - 12:00 PM America/Chicago

Presented by:

Presenters

Tanai Lobban

product owner, Solventum

Nichole DeLong

coding solutions advisor, Solventum.

Josh Amrhein

business manager, revenue integrity, Solventum

Julie Salomon

CDI business director, Solventum

Baptist MD Anderson doubled infusion volume with no new chairs

Infusion volumes at Baptist MD Anderson Cancer Center have more than doubled since 2019, topping 39,000 visits last year. Growth of that scale can swamp even seasoned nursing teams, elongate patient wait times and expose hidden scheduling gaps. Instead…

Sep 4, 2025 1:00 PM - 2:00 PM America/Chicago

Presented by:

Presenters

LeeAnn Mengel, RN, MBA, CMPE, FACHE

Vice President and Administrator, Baptist MD Anderson Cancer Center, Baptist Health

Christi Urman

Senior Account Manager, iQueue for Infusion Centers, LeanTaaS

EHR transformation enters a new phase — why cloud adoption is surging now

EHRs have evolved far beyond simple digital archives. Today, forward-thinking health systems are moving EHRs to the cloud to unlock faster performance, protect critical data and drive real innovation. This report summarizes perspectives from CIOs and chief medical and nursing…

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Oscar Health is latest insurer to cut earnings guidance

Oscar Health is expecting to operate at a loss in 2025 as costs climb in the individual market. The company reported preliminary results for the second quarter of 2025 on July 22, expecting a loss from operations of $200 million…

Humana to cut prior auth requirements, introduce gold card program

Humana is accelerating its efforts to reform the prior authorization process through a series of new policies, following the broader insurance industry’s recent pledge to reduce and streamline prior auth requirements. By January 1, 2026, Humana will eliminate one-third of…

Medicare Part D's 'uncertain' future: 5 things to know

The Medicare Part D market is facing an “uncertain future,” according to an analysis from KFF published July 16. The future of the Part D market depends on whether CMS extends the Part D premium stabilization program put in place…