CMS Reveals Essential Medicare Updates for 2027
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. CMS finalized sweeping Medicare payment reforms it says will shift the program from volume-based “sick care” toward prevention, primary care and accountable care. Read Full Article […]
Proven Financial Risks of Self-Funded Insurance
Direct answer The primary risk is unexpected high-cost claims, which can exceed the employer’s budgeted reserves if stop-loss insurance coverage is not appropriately structured. It depends on the size of your workforce and your historical claims data, which determine your risk tolerance. Actuarial analysis reports regarding employer-sponsored health plan insolvency risks. For additional information about […]
Proven Ways Health Plans Master Payment Operations
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. Exception volume, return rate and digital share show whether a plan bought capacity or architecture. Read Full Article on Source → 💡 What This Means For […]
Humana and Athenahealth Reveal Powerful New Authorization Tools
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. Humana and healthcare technology company Athenahealth are expanding electronic prior authorization capabilities, spanning more than 180,000 clinicians in Athenahealth’s network. According to a Nov. 3 news […]
How the FTC Is Making Powerful Healthcare Changes
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. The FTC sent warning letters to 25 health plan marketers over potentially deceptive marketing practices, following its earlier letters to healthcare services companies about price transparency. […]
Essential CMS Payments Secured for Rural Ohio System
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. Marietta, Ohio-based Memorial Health System is waiting on approximately $80 million in Medicaid supplemental payments pending CMS approval, CEO Scott Cantley told Becker’s. About $60 million […]
Centene Delivers Proven Profits After Smart Cuts
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. After a buoyant third quarter, Centene now thinks its Medicare business will break even one year ahead of schedule. Staffing cuts saddled the insurer with severance […]
Essential Guide: 698 Rural Hospitals Facing Closure Risk
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. Nearly 700 rural hospitals across the country, about one-third of all rural facilities in the U.S., are at risk of closing due to severe financial problems, […]
Aetna Takes Essential Action for Fair 2027 Star Ratings
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. CVS Heath’s Aetna is joining the ranks of insurers suing over its results in the 2027 Medicare Advantage star ratings. Read Full Article on Source → […]
3 Proven Ways ProgenyHealth Protects Infant Care
📰 Curated Industry Article This is a summary of a full article from a trusted healthcare and insurance publication. Click “Read Full Article” below to read the complete story. [Sponsored] Pregnancy and NICU admissions are among the most complex areas in healthcare. A new report from ProgenyHealth highlights how the company can work with Medicaid […]