Thirty-nine healthcare providers, along with the National Community Pharmacists Association, have filed a class action lawsuit against UnitedHealth Group – plus subsidiaries Optum and Change ...

The California Department of Health Care Services (DHCS) has joined with five commercial managed care plans (MCPs) in an agreement to deliver Medi-Cal services to Medi-Cal managed care members in 21 ...

UnitedHealth Group's OptumCare is acquiring Surgical Care Affiliates for $2.3 billion, Optum announced Monday. The acquisition of the outpatient surgery chain creates a comprehensive ambulatory care ...

The Centers for Medicare & Medicaid Services has revised the Medicare Advantage star ratings system in a final rule that is expected to give MA insurers $18.6 billion over the next decade. The changes ...

Thirty-seven percent of health systems are using generative AI within the rev cycle and 45% are applying it to denial-related ...

Meaningful progress requires alignment across providers, payers, EHR developers and others, not isolated adoption, CMS says.

Financial implications do not include high-stake bonus payments, but NIH data shows patients are willing to pay more, and ...

The initiative from the health system – a large provider of Medicaid services in Connecticut – is to ensure that patients who ...

Memorial Healthcare System's Jesus Diaz says seeking clinicians' direct input on their workflow needs during the development stage helped the organization successfully deploy new smartphones at a ...

AI moves the old concept of "chase to collect" to predicting and prevention, said Brian Kenah, CTO of EnableComp.

Insurers denied more claims on clinical grounds in 2025 compared with 2024, leading to a 25% increase in net revenue leakage at hospitals, according to a new report by Kodiak Solutions. Denials and an ...

Dr. Patsy McNeil is a practicing physician and executive vice president and chief medical officer of Adventist HealthCare, a Maryland-based health system with three acute-care hospitals on the East ...