Plus, Done executives charged with fraud

This Week

Jun 15, 2024

Blue Cross Blue Shield of Michigan pulling back on GLP-1 coverage


Teladoc taps GuideWell executive Chuck Divita as new CEO


Telehealth startup Done's CEO and clinical president arrested, charged with fraud


Oscar Health growth ambitions: Doubled footprint, planned ICHRA products launch and more


AMA, lawmakers aim renewed prior authorization crackdown on insurers - Paige Minemyer

 

Featured

Blue Cross Blue Shield of Michigan pulling back on GLP-1 coverage

Blue Cross Blue Shield of Michigan will pull back on coverage for GLP-1 drugs amid rising costs for these products.
 

Top Stories

Teladoc taps GuideWell executive Chuck Divita as new CEO

Virtual care giant Teladoc Health tapped a new CEO two months after longtime leader Jason Gorevic stepped away.

Telehealth startup Done's CEO and clinical president arrested, charged with fraud

According to the DOJ, Done's CEO and clinical president allegedly arranged the prescription of 40 million Adderall pills as well as other stimulants, generating more than $100 million in revenue.

Oscar Health growth ambitions: Doubled footprint, planned ICHRA products launch and more

Oscar Health execs outlined the company's three-year vision during June 7's investor day. The insurer plans to make more headway in the ACA market and ICHRA through robust expansion and strong financial performance.

AMA, lawmakers aim renewed prior authorization crackdown on insurers

A large coalition of bipartisan lawmakers and national advocacy organizations are renewing their efforts in reforming prior authorization.

Humana finds value-based care leads to fewer hospital admissions for kidney patients

A new report from Humana shows value-based care lowers medical expenses and is coupled with fewer inpatient utilization for its members needing kidney care.

Optum unveils new benefits management solution for durable medical equipment

Optum is rolling out a new offering that seeks to make it easier and faster for patients to secure durable medical equipment.

2024 shaping up to be a big year for healthcare AI companies. But some investors remain cautious

So far, in 2024, $2.8 billion has already been invested in AI healthcare companies, with SVB projecting the sector to see $11.1 billion in VC capital deployed across this year,

CMS projects national health spending grew 7.5% in 2023 to $4.8T

Record-high insurance coverage rates from pandemic policies alongside other trends like high utilization pushed health spending past the nominal GDP growth rate in 2023, according to new projections from government actuaries.

OSF HealthCare President Sister Diane Marie McGrew dies at 57

McGrew had served as president of the 16-hospital Franciscan health system since 2006, and also held longstanding roles on its various boards. No plans for her succession have been disclosed.
 
Fierce podcasts

Don’t miss an episode

Cybersecurity lessons from the Change Healthcare hack

In this week’s episode of “Podnosis”, Senior Writer Paige Minemyer sits down with Clearwater CEO Steve Cagle to explore the lessons healthcare organizations can learn from the Change Healthcare cyberattack and what it reveals about the industry’s current state of security readiness.  
 

Resources

Whitepaper

The Health Equity Index: How Health Plans Can Get Ahead

Medicare Advantage plans: learn how to leverage data, personalize social risk factor screenings, and collaborate for better health outcomes in our white paper, The Health Equity Index: How Plans Can Get Ahead of the Curve.

Whitepaper

Framework of Observation Care in Admission Decisions

Learn about the utilization patterns of Observation Care as well as the stability of Obs vs. Inpatient admission rates.
Whitepaper

Component Solutions for Implantable Medical Devices

Discover how Murata's small electrical components are revolutionizing implantable medical devices for enhanced reliability and performance.
 
 

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