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Getting a payer file is easy. Trusting it is not. In a late-2025 survey of 56 hospital and health system C-suite leaders, 87% said claims data matters to value-based care. Only 35% were confident it was accurate. Just 11% called…

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Your health system already earned the revenue, and now it’s sitting in a fax queue, in a denial nobody had time to appeal, and in an authorization that’s been pending for three weeks. See how health systems are clearing those…

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The 340B Drug Pricing Program remains among the financial and policy issues hospital CEOs are watching closely, amid legal challenges and potential changes to how hospitals receive drug discounts. Eligible hospitals currently receive 340B discounts up front when purchasing drugs.…

Plans are expecting Medicare Advantage enrollment of 34 million beneficiaries in 2027, or about 47.4% of all Medicare enrollees, according to a Sept. 28 CMS news release. This would be flat compared with the 2026 projection, but actual MA enrollment…

UnitedHealthcare and TeamHealth have settled a lawsuit in which the insurer accused the physician staffing company of upcoding emergency department claims.  The lawsuit was voluntarily dismissed with prejudice Sept. 24 in Tennessee federal court, according to court records. The dismissal…

University of Chicago Medicine has appointed Josh Denny, MD, its inaugural senior vice president for AI and precision medicine and chief data officer, effective November 2026. Dr. Denny, who will also serve as vice dean, has been CEO of the…

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