With a medical loss ratio of 82.2%, insurer Cigna has felt less pressure around medical costs than its peers, allowing the company to pull in $1.3 billion in profit during the first quarter of the year. While the medical loss ratio is higher than it was last year at this time (when it was 79.9%), […]
Transforming Episode Accountability Model (TEAM) is a mandatory episode-based payment model for acute care hospitals in five surgical specialties starting January 1, 2026, says HSBlox operations chief Lynn Carroll.
Hospitals across the U.S. are seeing both higher revenues and higher expenses, and operating margins have begun to contract slightly, according to March data published by Strata.
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.