The United States has filed a complaint against Aetna, Elevance and Humana  for allegedly paying millions of dollars in kickbacks to insurance brokers  eHealth, GoHealth and SelectQuote.  The brokers allegedly directed Medicare beneficiaries to the plans that paid them the most in kickbacks regardless of the suitability of the plans for the beneficiaries, according to […]

Residents and fellows are being taught through precise, right-to-the-point responses built by algorithms, says Dr. R. Ryan Sadeghian, pediatrician and University of Toledo CMIO.  

CVS Health has seen profit and revenue grow over the past year, logging $1.8 billion in profit for the first quarter of the year, and $94.6 billion in revenue (compared to $1.1 billion and $88.4 billion in Q1 2024, respectively). But the company’s insurance arm, Aetna, is struggling, and will exit the Affordable Care Act […]

The Supreme Court has ruled against hospitals in a case over disproportionate share hospital payments. The Justices handed up a 7-2 decision on Tuesday. 

Subject matter experts in the field are already scouting topics for HIMSS26 and decisions also rely on proposals received, says Michele Krajewski, chair of the committee.  

Providers can help offset shrinking reimbursements, inflation, rising operational costs and compliance requirements by cross-training staff and automating administrative tasks, says AdvancedMD CEO Amanda Sharp.  

Leadership changes are afoot at Optum, with parent company UnitedHealth Group announcing that Dr. Patrick Conway will become CEO of the division.

Humana took in $1.2 billion in profit in the first quarter of 2025, enough for the insurer to reaffirm its outlook for the year. Revenue clocked in at about $32.1 billion for the quarter, while earnings per share were $11.58.

Banner Health’s “Text the CEO” for patients to give direct feedback to executives started as a pilot in 2021 and has expanded to 125 locations, says Amy Adashek-Pinn, senior digital product manager.  

Patient financial platform Cedar has launched Kora, an AI voice agent that is projected to automate 30% of inbound billing calls by year-end.   The platform is trained on Cedar’s pre-existing billing data so that Kora is able to intelligently answer billing questions beyond traditional interactive voice response, Cedar said. It can explain charges, identify payment […]