Cigna subsidiary Evernorth Health Services will be investing heavily into Shields Health Solutions, pumping $3.5 billion into ...

Accountable Care Organizations saved Medicare $2.4 billion relative to benchmarks in 2024, and most ACOs are earning ...

An Alabama-based doctor has been charged and has agreed to plead guilty in connection with a $6 million telehealth fraud scheme involving medically unnecessary durable medical equipment (DME) and ...

Included Health uses tech infrastructure to incorporate care, plan, cost and quality data into one place that can be accessed by an app, says President Robin Glass, president of Included Health.

The No Surprises Act appears to be reducing out-of-pocket costs for consumers, with a new study from Harvard University and Mass General Brigham showing significant decreases in out-of-pocket spending ...

The House Committee on Oversight and Government Reform said last week that it’s expanding its investigation into the role of pharmacy benefit managers by seeking information about how they use foreign ...

The report also sheds light on Medicare Advantage reimbursement. Medicare Advantage plans pay physicians an estimated 10% to ...

The physician does the prescription in the background, Surescripts asks the PBM for prior auth approval and the information is pulled from the EHR, all within 30 seconds, says Matt Koehler, VP of ...

Northwestern University and Chicago-based health system Endeavor Health have developed a new computer program that can help ...

Digital health company Waltz Health and life sciences company Eversana are merging to create a combined pharmaceutical ...

In June, CMS issued the final rule, “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability.” ...

After 12 years of litigation, Blue Cross and Blue Shield and providers have reached a $2.8 billion settlement in federal ...