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A real-time data initiative helped Healthfirst improve follow-up rates for patients visiting emergency rooms for mental health and substance use conditions.  A national challenge for the industry is that relying on claims data alone is not fast enough to ensure…

Blue Shield of California is cutting broker commissions for new enrollments into Medicare Advantage PPO plans in Alameda, Orange and San Diego counties, effective July 1. The new policy does not affect commission payments of existing membership, according to a…

In June, around 50 insurers pledged their commitment to a set of voluntary actions aimed at simplifying the prior authorization process. The group of insurers, backed by leaders including CMS Administrator Mehmet Oz, MD, said they will work to implement…

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An Ohio state judge has temporarily barred a Texas-based insurer that sold health insurance plans to retired law enforcement and fire personnel from operating in the state due to violations of insurance laws.  On June 25, a Franklin County judge…

Effective data interoperability in healthcare is no longer an optional enhancement; it’s an essential function for modern medical systems. With its potential to significantly improve operational efficiency and patient outcomes, interoperability ensures seamless communication between diverse healthcare systems. Federal mandates…

Clear answers to questions are the top driver of members’ experience with their insurers, according to a report from Forrester.  The research firm scored insurers on the brand experience index, which measures customers’ and noncustomers’ brand perception, and customer experience…

GuideWell, the parent company of Florida Blue and several health services companies, was ranked on the Fortune 500 for the first time.  Guidewell, a not-for-profit mutual holding company, was ranked No. 136 on the list.  In a June 25 LinkedIn…

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