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November 2-3, 2023 | Austin, TX Payer leaders will come together to unpack the evolving landscape, providing a deep dive into the most important issues facing the industry. Book now & Save $200 on Registration. 
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| By Frank Diamond Beneficiaries switching from fee-for-service Medicare to Medicare Advantage more than tri-pled between 2006 and 2022. Conversely, switching from MA to traditional Medicare decreased. |
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| Philadelphia, PA |  |
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By Noah Tong Based on care models out of Maryland, Vermont and Pennsylvania, CMS is implementing the AHEAD Model to help states address chronic disease. |
By Anastassia Gliadkovskaya Unite Us, the tech company facilitating referrals to social services, has laid off a sizable chunk of its workforce, Fierce Healthcare has learned. |
By Paige Minemyer As more and more cell and gene therapies come to the market, these high-cost drugs are set to have a major impact on cash-strapped Medicaid programs, according to a new analysis from Prime Therapeutics. |
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Thursday, September 21, 2023 | 2pm ET / 11am PT This presentation will discuss the critical need for race, ethnicity and SDOH data and review the CMS Framework for Health Equity, early insights into the newly stratified HEDIS measures and how different populations performed on 2022 Health Equity Measures. We will also talk about food deserts and provide recommendations for health plans. Register now. 
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By Dave Muoio Recent study data outline physicians' tendency to point patients toward their associated health system's specialists, EDs and hospitals after joining up. Though readmission rates did not appear to change, the trend raises concerns about unnecessary spending. |
By Heather Landi Ambulatory technology company NextGen Healthcare agreed to be acquired in a take-private deal with private equity firm Thoma Bravo. The deal is valued at $1.8 billion, according to media reports. |
By Paige Minemyer Humana has filed suit against the feds, saying the Biden administration's bid to claw back overpayments in Medicare Advantage is built on "shifting justifications and erroneous legal reasoning." |
By Dave Muoio Offices like the CDC and CMS see many more appointees of different career backgrounds leaving for the private sector, a trend that researchers say deserves greater scrutiny to ensure agency decision-making is not being compromised. |
By Paige Minemyer Former UnitedHealthcare executive Roger Rodriguez said that during his tenure with the insurance giant, he endeavored to view payer issues through a provider lens. |
By Noah Tong Complaints against Blue Cross and Blue Shield of North Carolina appears to have prompted the insurer to backtrack and remove 48 HIV drugs from its costliest drug tiers. |
Fierce podcasts Don’t miss an episode |
| This week on "Podnosis," we take a closer look at the challenges with new email policies, and the importance of diverse investors and founders. |
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Wednesday, September 27, 2023 | 2pm ET / 11am PT Many providers are now leveraging virtual care programs to optimize the delivery of care, reach patients in remote locations, mitigate chronic disease management, improve care quality, and increase patient satisfaction. Join us for this panel discussion to explore how improving access to healthcare virtually can make a positive impact on your business economics as well. Register now. 
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eBook Patient expectations for great experiences are higher than ever, but fragmented patient journeys across channels and data silos are impacting patient experience, acquisition, and loyalty. Here is what your organization can do to match patient expectations. Sponsored by: Talkdesk |
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