Payer

Federal and state regulators are turning up the heat, especially in Medicaid and Medicare Advantage. From heightened audit activity to stricter diagnosis coding rules, payers are under growing pressure to get documentation, chart reviews and claims submission right the first…

New CMS reimbursement policies and Medicaid redeterminations are straining hospital revenue — especially in markets with high exchange plan enrollment. Health systems can’t afford to rely on legacy growth strategies. In this session, marketing, strategy and finance leaders will explore…

Rising administrative costs, complex compliance demands and shifting member expectations are straining payer operations. For many Blue Cross Blue Shield organizations, siloed data is the biggest barrier to delivering consistent, personalized member experiences. This live discussion will break down how…

Federal healthcare policy is shifting fast. Expiring pandemic-era tax credits, research funding cuts and increasing prior authorization pressures are already reshaping how care is delivered and reimbursed. During this virtual learning session, hear from two Cigna senior leaders on how…

Many health plans still rely on basic segmentation and static messages — leaving members feeling like numbers. But the stakes are rising fast: With heightened expectations and fierce competition, payers must deliver timely, relevant experiences to keep members engaged. Join…

Value-based care can’t succeed without payer-provider alignment. Yet, most organizations still struggle to share clinical and claims data in a timely, actionable way. This webinar explores how real-time, bidirectional connectivity is helping care teams move from fragmentation to coordination —…

Despite shared financial pain points, payers and providers remain locked in misalignment. Denials are up. Administrative costs are rising. And relationships are more strained than ever. What if collaboration didn’t have to be so hard? This webinar explores real-world data…

For many payers, utilization management is still synonymous with prior authorization. But that narrow view can lead to missed opportunities, care delays and member dissatisfaction. This session explores how leading health plans are reframing UM as a proactive strategy to…

Venous leg ulcers (VLUs) remain one of the most persistent, costly chronic wounds in payer networks. Current treatments often fall short and coverage policies overlook promising alternatives. But new clinical evidence may change that. Join a discussion that explores findings…

Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom. This webinar breaks down new national research on UM practices across…