New & Notable
Medicare GLP-1 program sees rapid uptake among seniors
CMS Administrator Mehmet Oz says 600,000 seniors have signed up for discounted GLP-1s through Medicare Bridge, projecting taxpayer savings through reduced hospitalizations.
Centene taps Fannie Mae executive as CIO
Bradley Bolivar is taking the reins of Centene’s IT strategy as artificial intelligence drives a sea change for how insurers do business.
— Healthcare Dive
Cigna links supplemental benefits with medical plans
In 2027, employers can offer Medical with Smart Coverage, which allows them to connect supplemental benefits to high-deductible health plans.
How employers are rethinking benefits as healthcare costs soar
A new survey shows that employers are looking to value-based models, deeper vendor partnerships and potentially alternative health plans to control rising healthcare costs.
Prior authorization denials vary widely among insurers, first-of-its-kind data shows
— Healthcare DiveSponsored Sites
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Social Determinants of Health
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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80% of adults unfamiliar with Medicaid work requirements
Medicaid work requirements are set to begin in January, putting pressure on states to educate members about the program requirements to prevent loss of coverage.
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Black, Hispanic patients underrepresented in value-based care models
White, high-income patients living in urban areas are more likely to benefit from value-based care models, limiting the generalizability of model results.
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State-based subsidies saved some ACA Marketplace losses
States that offered their own subsidies to consumers had lower ACA Marketplace enrollment losses, according to new KFF data.
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CMS fraud war room stops $203M in debated Medicaid payments
In less than 90 days, the new Medicaid Fraud War Room blocked payments to 50 unique providers at high-risk of defrauding the federal healthcare program, the CMS says.
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OIG calls on states to tamp down Medicaid provider fraud
States must create more specific contracts with Medicaid MCOs detailing requirements for Medicaid provider fraud referrals, OIG advised.
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Aetna: Docs trust payers more even as administrative burden persists
Although providers are trusting payers more, there's an opportunity for health IT to ameliorate administrative burdens, including prior authorizations.
Features
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Inside Elevance's digital chronic disease management strategy
The payer uses multiple chronic disease management programs to avoid a one-size-fits-all approach to member engagement.
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5 healthcare pros on the trends defining primary care
The 2025 Payer + Provider Virtual Summit explored AI, value-based care and community-based partnerships, offering strategies on how to promote primary and preventive care.
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How payers can regain consumer trust via personalized care
Creating personalized health plans is central to regaining consumer trust. To do that, payers must outline safeguards for member data and create seamless experiences.
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With trust low and costs high, do payers stand to lose members?
Healthcare payers might see fewer enrollments as members face higher prices for a product they don't trust or see as high value.