Payer Issues E-Newsletter

January 7, 2020

1. CMS proposes risk adjustment updates to Medicare Advantage: 5 things to know Full story

2. 2 San Diego physicians pay $949K to settle billing fraud allegations Full story

3. 'No guarantee of payment': Healthcare cost-sharing ministries face growing scrutiny Full story

4. T-minus 12 months until CMS price transparency: Is your team ready? Click here to attend a live price transparency primer.

5. Thrilled to welcome terrific health system CEOs Lloyd Dean, CommonSpirit Health; Nancy Howell Agee, Carilion Clinic; Sister Mary Haddad, Catholic Health Association of the United States; Rod Hochman, MD, Providence St. Joseph Health; Wright Lassiter III, Henry Ford Health System; Warner L. Thomas, Ochsner Health System; Stephen Klasko, MD, Thomas Jefferson University & Jefferson Health; Michael A. Slubowski, Trinity Health; and Melinda L. Estes, MD, Saint Luke's Health System, to the Becker's Hospital Review 11th Annual Meeting. Register here. For exhibiting and sponsorship opportunities, email Jessica Cole at

6. Cigna: Merging pharma, medical, mental health benefits saved hundreds per member Full story

7. Oscar Health drops Walgreens from pharmacy network Full story

8. 3 Must Reads: 

  • Advances in print technology can help support clinical stakeholders in their quest to provide the best value-based patient care.
  • Value on investment: Why ROI alone can't measure project success in healthcare. Read this white paper to learn how to measure the intangibles that contribute to success.
  • 3 ways executives can lead change, 7 things keeping revenue cycle executives up at night and more. 8 C-suite must-reads from 2019.

9. Former Target CFO takes on same role at health insurance startup Bright Health Full story

10. Molina to acquire Illinois Medicaid plan for $50M Full story

11. In 2019, more healthcare records were breached than in all of 2016, 2017 and 2018 combined. Attend this live online discussion for insights into proactive approaches to data security.

12. Medicare Part B paid for $725M drugs that were thrown away Full story

13. Horizon BCBS rebates members $40.5M in overpaid premiums Full story

14. Steward Health Care closes sale of health plan Full story



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