“For insufficient a far better way to set it, your transparency has to be clear,” Lennox-Miller reported. “In the event you’re showing how your algorithm functions, and it's merely a math equation or an extremely complex list of documents, that does not support.”
Elevance lowers steering on ‘unparalleled’ Medicaid issues Executives explained the amplified costs pressuring its Medicaid company would enhance just after states up to date payment prices to raised match member acuity.
Why Cigna is capping Charge raises for pricey GLP-1 weight reduction medication The transfer — the 1st of its sort — will come as pharmacy reward managers carry on to try to verify their worth to customers, and displays how main players are shoring up to meet sky-substantial GLP-1 desire.
Teladoc COO to depart at year end Mike Waters’ resignation follows other Management adjustments in the telehealth seller, such as the departure of Teladoc’s former CEO this spring.
Payer/service provider interactions As M&A intensifies and firms embrace additional holistic and benefit-centered treatment styles, partnerships have become much more intently intertwined.
Hear the article ten min This audio is auto-created. Make sure you let's know if you have feed-back. Electronic wellbeing and health and fitness engineering adoption Superior swiftly in the wake of the COVID-19 pandemic, as Trader bucks flooded into the Place and vendors speedily picked up telehealth capabilities.
A Cigna-Humana merger could face a protracted regulatory click here hold off. But it'd get approved. As rumors swirl which the two key health and fitness insurers are inching toward a merger, authorities say antitrust agencies have grounds to block a offer — but is probably not thriving.
FTC sues important pharmacy advantage administrators around insulin charges The company brought motion versus Caremark, Convey Scripts and Optum Rx, arguing their “anticompetitive and unfair” rebating tactics “artificially inflated” the list cost of everyday living-saving insulin medicines.
Top healthcare conferences to system for in 2025 Allow me to share noteworthy events medical center, payer and tech executives ought to think about attending future year, running the gamut from electronic wellness to money management to medical innovation.
Two-thirds of healthcare businesses strike by ransomware in earlier yr: survey Just about forty% of healthcare companies described it took a lot more than per month to Get well right after an attack, Based on a study by cybersecurity organization Sophos.
An report from Prime healthcare trends in 2024 Listed here’s what sector authorities see coming down the pike for hospitals, insurers and electronic wellness companies this calendar year.
Medicare Benefit unrest, Improve Healthcare fallout and even more major takeaways from insurers’ Q1 All main payers observed elevated utilization but only an unprepared several struggled Together with the craze, the Transform Healthcare cyberattack induced minimal economical fallout and a new D-SNP rule opens the doorway to the Medicare development chance.
Senate report slams Medicare Gain insurers for working with predictive technological know-how to deny promises UnitedHealth, CVS and Humana applied engineering to improve MA prior authorization denials for write-up-acute products and services, boosting revenue, In accordance with a report from a Senate subcommittee.
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