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Weekly Top Stories

Tue, 13 Nov 2018
1. Transitioning Payment Models: Fee-for-Service to Value-Based Care
2. BCBS of South Carolina to lay off 244 employees
3. Humana rides high in third quarter on MA revenue & membership growth
4. Oklahoma family wins $15M settlement over denied Aetna coverage
5. Change, TIBCO use blockchain to build smart contract system for payers
6. UnitedHealth, Centene poised for gains after 3 states expand Medicaid
7. CVS expects deal with Aetna to close by Thanksgiving
8. Conduent To Acquire Health Solutions Plus For Payer Software
9. CMS to Audit Premium Subsidy Eligibility for Individual Health Plans
10. Google to appoint Geisinger CEO as healthcare services head
11. Humana CEO: ‘We’ll Continue To Build’ Walgreens, Walmart Relationships

About Our Editor - Susheel Ladwa Susheel is passionate about health care, he has over two decades of experience working with Payers, Providers and PBMs. He chairs AHIP's IT Workgroup and is a featured speaker at multiple conferences.
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BlueCross BlueShield of South Carolina is letting go 244 workers after losing a Veterans Administration Choice contract, according to The Post and Courier. The cuts, which affect employees across BCBS of  ...
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Humana is the latest insurer to report earnings gains during the third quarter driven by its Medicare Advantage business. Humana earned $901 million, compared to $799 during the third quarter a year ago. Total earnings..
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A judge awarded an Oklahoma family a multimillion-dollar settlement after the family sued Aetna over its proton therapy coverage, according to Oklahoma’s News 4. Ron Cunningham and the estate of his,...
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Change Healthcare and TIBCO Software are collaborating on a smart contract system for payers to automate the claims transaction process using blockchain, the companies announced Monday. Smart contracts enable entities that need to see the ...
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Three states — Idaho, Nebraska and Utah — voted in favor of expanding Medicaid Nov. 6, a decision that could benefit health insurers who are growing their managed care businesses, according to Forbes contributor Bruce Japsen. Approval ...
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CVS profits in Q3 decreased 5.8 percent to $2.4 billion, driven by a $64 million increase in acquisition-related transaction and integration costs. The $69 billion acquisition of Aetna is expected to close prior to Thanksgiving, according...
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Conduent has agreed to acquire Health Solutions Plus for an undisclosed sum. HSP has developed well-regarded healthcare payer administration software. Over the medium term, CNDT stands to gain a stronger offering in the..
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CMS has proposed a new rule that would audit premium subsidy eligibility for individual health plan beneficiaries and monitor premium assistance programs through the federalinsurance exchanges. The Patient Protection and Affordable Care ...
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“Not factoring in Alphabet, which has Verily and Calico, multiple groups within Google are interested in health”. David Feinberg is moving to the new Google health-care post after leading the Geisinger health system ...
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Humana said its relationships with Walgreens Boots Alliance and Walmart to establish closer ties with national retail healthcare providers is going well amid a new pilot program launched this year. Humana is closely monitoring a now three...
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