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In September, CMS rebranded individual coverage health reimbursement arrangements as CHOICE arrangements, short for Custom Health Option and Individual Care…
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The Blue Cross Blue Shield Association is bringing its data and analytics work “under one internal umbrella,” the organization confirmed to Becker’s Oct. 9. The former CEO of Blue Health Intelligence, an analytics company that has been a BCBSA licensee,…
Fortune recognized five healthcare companies on its 2026 “AIQ 75” ranking. Fortune partnered with Enterprise Technology Research and pulled from ServiceNow’s Enterprise AI Maturity Index. The team assessed how Fortune 500 companies, the largest U.S. companies by revenue, deploy AI…
Medicaid members with behavioral health conditions pass through emergency departments, inpatient units and outpatient follow-up as though each were a separate system. For most plans it is, and the members who need coordination most are the least likely to get…
Presented by:
- Kristi Carney, Director of Behavioral Health, CareSource, Indiana Market
- Nishi Rawat, MD, Chief Clinical Officer and GM Care Navigation, Bamboo Health
Thirty-two Medicare Advantage contracts received 2.5 stars or lower in CMS’ 2027 star ratings, up from 23 last year. The agency released the ratings Oct. 8, which will determine quality bonus payments for 2028. The enrollment-weighted average MA star rating…
In a new lawsuit, Michigan Attorney General Dana Nessel is accusing Blue Cross Blue Shield of Michigan of conspiring with other Blues plans to block competition and using its grip on the health insurance market to overcharge the state and…
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Advocate Health, based in Charlotte, N.C., seeks an area vice president of managed…
Dispute activity under the No Surprises Act continues to evolve, court decisions are influencing the regulatory landscape, and the Final Rule could change how health plans and healthcare organizations approach key requirements. This session offers a data-driven look at where…
Presented by:
- Jennifer Forcash, Assistant Vice President Surprise Bill Solutions, Claritev
Humana and the University of Louisville reported Oct. 6 that the company contributed nearly $20 billion to the state’s revenues and output in 2025. This includes estimates of roughly $6.4 billion in direct impact, $9 billion in indirect impact and…
A Florida appellate court ruled Oct. 7 to expunge a grand jury report regarding a $10 million Centene donation to the Hope Florida Foundation, tied to Florida’s first lady, Casey DeSantis. Florida prosecutors launched a criminal investigation into the donation,…
Medicaid members in the Bronx will be exempt from new federal work requirements when they take effect Jan. 1 because the county meets the law’s unemployment threshold, the New York State Department of Health said in statements to Becker’s. Under…
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