A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny Medicare Advantage members post-acute care. The March 9…
The Latest
Medicare premiums may go up as rival insurers acquire pharmacy benefit managers, according to a January study published in the American Economic Journal: Applied Economics. “The PBM has an incentive to potentially disadvantage the rival insurers, which could involve passing…
Many DSOs expanded quickly during the zero-rate era, but integration often did not keep pace. As capital costs rise, fragmented systems, manual processes and decentralized operations are becoming harder to ignore. For today’s DSOs, the pressure is no longer just…
Presented by:
Early signs of conditions like dementia are often first observed in primary care. Yet confirming and documenting those changes still relies on overextended specialists and time-intensive evaluations. The result: delayed detection, unnecessary referrals and missed opportunities for early intervention. In…
On Demand
Presented by:
Presenters
Dr. Anthony Zizza
Chief Medical Officer, Element Care
Julie Miyamasu
Clinical Strategy Director, Care Transformation, Advocate Health
Professor Adrian Owen
Cognitive Neuroscientist and Chief Scientific Officer, Creyos
The demographics and clinical statuses of Medicare Advantage enrollees have been getting more diverse over time, according to research published March 10 in the American Journal of Managed Care. The researchers reviewed enrollment files and pharmacy data spanning 2012 to…
Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for its Medicare Advantage enrollees in order to increase payments from CMS. The settlement…
Gov. Tim Walz unveiled a proposal March 10 to eliminate managed care organizations from the state’s Medicaid program and replace them with a single statewide organization. Currently, about 45% of the state’s Medicaid spending and nearly 80% of basic care…
Elevance said it was “surprised and disappointed” by a recent CMS sanction threat, which would suspend enrollment in Medicare Advantage prescription drug plans, CFO Mark Kaye said March 10 at the Barclays 28th Annual Global Healthcare Conference in Miami. The…
Centene expects its ACA membership to fall nearly 40% by the end of 2026, company executives said March 11 at the Barclays 28th Annual Global Healthcare Conference. CEO Sarah London said the company ended 2025 with 5.5 million members in…
Most virtual health pilots fail not because of the technology — but because of how they’re architected from the start. Without defined exit criteria, integration benchmarks, or measurable system impact, even promising pilots stall before reaching production. This session brings…
On Demand
Presented by:
Presenters
Jason Ward
VP of Information Systems Collette Health
Maruf Haider, MD
Associate Chief Medical Information Officer, Digital Health Carilion Clinic
Alen Oganesyan, MPA, CHCIO, CDH-E
Associate Chief Information Officer Keck Medicine of USC
Albert Villarin, MD, MBA, FACEP
VP, Chief Medical Informatics Officer Nuvance/Northwell Health
Greta Branford, MD
ACMIO, Associate Medical Director for Healthcare IT, Michigan Medicine