Minnesota Gov. Tim Walz has paused payments for 14 high-risk Medicaid services for up to 90 days while a third-party audit is conducted. The state’s Department of Human Services has contracted with Optum, which will analyze Medicaid fee-for-service claims data…
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Centene’s prescription drug plan enrollment is driving Medicare performance, contributing about half of the segment’s revenue, according to an Oct. 29 earnings call. Centene’s premium and service revenue reached $44.9 billion in the third quarter of 2025. Medicare prescription drug…
Inefficiencies in documentation, contracts and workflows quietly chip away at revenue. Outdated revenue cycle management (RCM) practices can cost physician groups hundreds of thousands each year. Without a comprehensive operational review, many practices never realize how much potential income is slipping through the cracks.…
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CVS Health boosted its guidance despite a $4 billion loss. The company documented $103 billion in revenue for third-quarter 2025, according to an Oct. 29 financial report. Revenue was up 7.8% year over year. The company raised its outlook and…
Centene reported a $6.6 billion loss in 2025’s third quarter but landed $49.7 billion in revenue, the company shared in its Oct. 29 earnings release. The company cited the One Big Beautiful Bill Act and a dip in its stock…
UnitedHealth Group is projecting its Medicare Advantage enrollment will decrease by 1 million people in 2026. That estimate is up from a 600,000-member decrease it projected in July. UnitedHealthcare CEO Tim Noel said on the company’s Oct. 28 earnings call…
Allentown, Pa.-based Lehigh Valley Health Network said it is planning to terminate its contract with UnitedHealthcare unless the payer works with the health system to remedy reimbursement issues. Without a resolution, LVHN will go out of network with UnitedHealthcare’s Medicare…
Manual barcode scanning is prone to missed steps, scan failures and inconsistent replenishment. For pharmacy teams managing hundreds of trays, the inefficiencies add up, draining valuable working hours and compromising safety. That was the case at Pasadena, Calif.-based Huntington Health.…
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Optum Health, UnitedHealth’s care services division, “strayed from the initial intent,” said Optum CEO Patrick Conway while discussing the unit’s performance during UnitedHealth Group’s Oct. 28 earnings call. However, he remained confident that the company can push the business forward. Mr.…
Most health systems know they need stronger career pathways, but choosing the wrong educational partner can derail those efforts, leaving staff with credentials that don’t count and training that doesn’t stick. This whitepaper is a playbook for making the right…
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