New & Notable
Here’s how much insurers are cutting Medicare Advantage plans for 2027
Newly released CMS data gives the market its first comprehensive look at how insurers are adapting to continued pressure in the privatized Medicare program.
— Healthcare Dive
Cigna, OpenAI partner on AI-driven personalized cancer care
OpenAI's technology will draw on Cigna's data and care management capabilities to produce individualized outreach and engagement.
AHIP: Medical costs, prescription drugs dominate premium dollar spend
The payer industry's primary lobbyist outlined a cent-by-cent breakdown of premium dollar spending, claiming hospital and prescription drug costs are the biggest expenses.
Self-funded employers pay the price for IDR problems
A new report finds that self-funded employers are struggling to manage the volume and added costs of the federal IDR process.
New lawsuit targets Medicaid work requirements’ medical frailty rules
— Healthcare DiveFederal watchdog accuses Humana, UnitedHealthcare Medicare Advantage plans of upcoding
— Healthcare Dive2.3M young adults could lose Medicaid due to Big Beautiful Bill: study
— Healthcare DiveSponsored Sites
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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Cybersecurity
Commvault + Microsoft
Together, Commvault and Microsoft are redefining cybersecurity and data resilience with a comprehensive, integrated platform, purpose-built to secure, defend, and recover data wherever it lives with true cloud simplicity, intelligence, and scale.
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Social Determinants of Health
PointClickCare
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
View All Episodes
Latest News
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Seasonal work risks Medicaid work requirement compliance
One in five adults at risk of noncompliance with Medicaid work requirements already work, with their hours just missing the 20-hour requirement set out by CMS.
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Medicare GLP-1 program sees rapid uptake among seniors
CMS Administrator Mehmet Oz says 600,000 seniors have signed up for discounted GLP-1s through Medicare Bridge, projecting taxpayer savings through reduced hospitalizations.
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Cigna links supplemental benefits with medical plans
In 2027, employers can offer Medical with Smart Coverage, which allows them to connect supplemental benefits to high-deductible health plans.
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How employers are rethinking benefits as healthcare costs soar
A new survey shows that employers are looking to value-based models, deeper vendor partnerships and potentially alternative health plans to control rising healthcare costs.
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Employee health benefits to spike 9.5% in 2027
Researchers said employers will work on benefit design and overall employee wellness to try to cap the rising cost of employee health benefits.
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Medicare Advantage member satisfaction lags for second consecutive year
Experts say poor member satisfaction and engagement have damaged overall consumer trust in their Medicare Advantage plans.
Features
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Can Costco hack Medicare Advantage's consumer loyalty problems?
Costco announced it'll sell Medicare Advantage plans in partnership with SCAN Health Plan, testing the wholesaler's consumer loyalty in a new market.
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Inside Elevance's digital chronic disease management strategy
The payer uses multiple chronic disease management programs to avoid a one-size-fits-all approach to member engagement.
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5 healthcare pros on the trends defining primary care
The 2025 Payer + Provider Virtual Summit explored AI, value-based care and community-based partnerships, offering strategies on how to promote primary and preventive care.
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How payers can regain consumer trust via personalized care
Creating personalized health plans is central to regaining consumer trust. To do that, payers must outline safeguards for member data and create seamless experiences.