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As insurers pivot their market and product strategies, executive leadership has been evolving at health plans and their parent companies. …
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Booking an appointment with a provider often means confirming they’re in network, working through an automated phone menu and trading available times with a receptionist. But for some UnitedHealthcare and Aetna members, an AI agent is now handling that work.…
A Clover Health July data breach affected 138,677 people, according to a notice filed with HHS’ Office for Civil Rights. Clover flagged the incident to the Securities and Exchange Commission on July 17 after first learning of unauthorized activity on…
Ask a health plan executive what they want AI to do, and they’ll usually answer with a goal, faster credentialing, cleaner directories, fewer complaints. But AI isn’t the goal. It’s one way to get there, and for most of what…
Presented by:
- Chris Lance, Chief Product Officer, Quest Analytics®
- Adam Sullivan, VP of AI, Change Healthcare, Labcorp
San Francisco-based Dignity Health, part of Chicago-based CommonSpirit, reached an agreement to transfer its share of co-owned Arizona managed care health plan, Mercy Care, to CVS Health subsidiary Aetna. CommonSpirit had a 49.75% ownership interest in Mercy Care as of…
Federal employees and retirees will pay 10.9% more on average for their health insurance premiums in 2027, marking the third consecutive year of double-digit increases. The U.S. Office of Personnel Management released the 2027 rates Sept. 30, framing the figures…
CareSource has named Stephanie Williams as its new chief financial officer. She succeeds Larry Smart, who will be retiring after serving as the insurer’s CFO for 6 years, according to an Oct. 1 news release. Ms. Williams first joined CareSource…
By the time MLR pressure shows up in your numbers, the margin may already be locked into the quarter. The question is whether you’ll spot the signals early enough to change the outcome. Most health plans don’t recognize margin pressure…
Presented by:
- Stewart Hinrichsen, Senior Director, Value-Based Strategy, Martin's Point
- Raj Lakhanpal, Chief Executive Officer, SpectraMedix
- Sean Kelly, Senior Vice President, Growth and Business Development, SpectraMedix
- Charles Chervitz, Consultant, SpectraMedix
Tacoma, Wash.-based MultiCare Health System is launching a health insurance plan. MultiCare Health Plan, announced Oct. 1, will operate as a wholly owned subsidiary of the 13-hospital nonprofit system. Its first product is a Medicare Advantage HMO with prescription drug…
A Massachusetts federal judge dismissed claims against Aetna on Sept. 30 in antitrust litigation over the use of Zelis’ repricing tools. The judge determined the providers’ latest complaint did not plausibly allege Aetna used the tools. The plaintiffs filed a…
Cigna is launching a modernization and productivity initiative, expected to bring in $3 billion in savings by 2030. During the company’s Sept. 30 investor day call, CFO Ann Dennison said the multiyear program focuses on automating workflows, ensuring a future-ready…
Popular in Executive Moves
How leading health systems scale virtual care across the enterprise
Presenters: Detra Moore, FACHE, Advocate HealthManish Sapra, MD, MMM, FAPA, CommonSpirit HealthDaniel Feinstein, MD, MS, ACRP, FACP, Novant HealthMeena Mallipeddi, AmplifyMD
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