Sentara Health notified Anthem that it will let its commercial, Medicare and Medicaid contracts expire at year's end unless the two sides reach a new rate agreement. The dispute puts coverage for an estimated 380,000 Virginians at risk.
Daffodil Health launched an AI-powered solution to help payers manage No Surprises Act disputes by automating claims review, negotiations and arbitration workflows.
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
MedCity News' new event for healthcare investors and corporate business development leads — Bullseye — hit the mark when it comes to provocative and thoughtful commentary. Here's what was said in panels throughout the day.
The between a code that satisfies a payer and the information a physician needs to treat a person, is what nearly every healthcare AI tool is racing past. As we push these systems toward precision medicine and genomics, that gap stops being an annoyance and becomes a patient safety issue.
Included Health announced plans to acquire Firefly Health to accelerate its alternative health plan strategy for employers.
When staff are overextended and patients face delays or abandon care, the issue is no longer a narrow administrative burden. It becomes a business, financial, and access challenge that demands a different operating model.
In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable.
On a recent webinar sponsored by Verato, panelists from SCAN Health Group and the Alliance of Community Health Plans discussed how their organizations are meeting the moment.
VBC aligns reimbursements to outcomes, emphasizing the quality and effectiveness, not quantity, of healthcare activities. But the same cost constraints driving interest in VBC can also turn it into a liability.
Drug spending continues to grow, but that doesn’t mean that everyone is getting the medicines that they need. A panel at MedCity News’ Bullseye event discussed the evolution of the prescription drug marketplace.
Priority Health partnered with Color Health and Grail to offer self-funded employers virtual cancer navigation, support and multi-cancer early detection beginning in 2027.
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
SCAN Health Plan CEO Sachin Jain and Ascendiun CEO Paul Markovich argued that healthcare leaders share responsibility for the industry's shortcomings and called for greater accountability and systemic reform.
At the end of the day, the most important question is a simple one: Do you actually know if you’re being reimbursed correctly?
Rep. Angie Craig introduced a bill to establish a public health insurance option on the ACA marketplaces and permanently extend enhanced premium tax credits.
A five minute survey from MedCity News asks payers what they think of AI and how it is being implemented. Participate today and we will reward you!
HSS chief digital and information officer Ashis Barad, who has worked on both the payer and provider sides of healthcare AI, thinks the industry's growing "bot vs. bot" battle over prior authorizations and appeals is driving costs up. To him, the real fix lies in providers and payers sharing data to build more personalized care pathways.