New & Notable
Humana's CenterWell acquires MaxHealth primary care clinics
CenterWell's acquisition of MaxHealth's primary care clinics is another step in a growing trend of health insurance vertical integration.
Employee health plan costs eat up 10% of wages
The U.S. is teetering on a healthcare affordability crisis, as employee health plan premiums and deductibles represent 10% of wages and salaries stagnate.
Cigna to lay off 2,000 workers worldwide
Cigna’s layoffs follow other recent downsizing announcements from health insurers looking to cut costs during an era of heightened medical spending.
— Healthcare Dive
Aetna launches digital onboarding to boost member experience
Aetna's investment in digital onboarding is indicative of a growing payer trend toward enhanced digital member experiences.
Sponsored Sites
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RCM Management
ZOLL Data Systems
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Interoperability
Veradigm Network to Payer
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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.
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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Medicaid improper payments increase, reaching $37.39B
Medicaid, CHIP and Medicare Advantage all saw increases in improper payment rates in FY 2025, while Medicare fee-for-service's rate remained below 10%.
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2026 ACA enrollment lags by 1.5M signups amid subsidy fight
ACA marketplace enrollment decreased for the first time since 2020, potentially due to lapsed premium subsidies.
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Medicaid work requirements to cause 1M missed cancer screenings
Medicaid coverage losses will impact how many people can access preventive care, resulting in a million missed cancer screenings.
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Abridge partners with Availity for AI-powered prior authorizations
Abridge took its next step in powering prior authorizations with AI; this time, the company teamed up with Availity to use conversational intelligence for real-time prior authorizations.
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Anthem sues 11 hospitals over No Surprises Act disputes
Anthem accused Prime Healthcare hospitals of flooding the IDR process with ineligible claims, resulting in $15M more in payments for out-of-network care.
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Trump administration ups payer price transparency requirements
The federal government proposed major updates to the Transparency in Coverage rule, including data disclosure changes for in-network rates and more robust consumer-friendly disclosure.
Features
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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.
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With trust low and costs high, do payers stand to lose members?
Healthcare payers might see fewer enrollments as members face higher prices for a product they don't trust or see as high value.
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Breaking down the ABCs of rising alternative health plans
More employers are seeking alternative health plans, like AHPs and ICHRAs, to bend the cost curve, but education is key to navigating their growing popularity.