In this episode,Jakob Emerson, Associate News Director, Becker’s Healthcare, examines the growing litigation over Medicare Advantage star ratings and the billions of dollars tied to quality bonuses. He also explores how AI is intensifying the coding and claims battle between health systems and insurers, creating new operational and financial challenges across the industry.

Medicare Advantage Litigation and the AI Battle Between Payers and Providers with Jakob Emerson

Becker’s Healthcare Podcast

There's a version of AI and healthcare that lives mostly in press releases, pilot programs, partnership announcements, theoretical use cases. And then there's the version that lives in the work. The CIO trying to get a model into production without breaking a dozen workflows. The revenue cycle leader weighing automation against accuracy. The CISO who knows that every new integration is a new attack service.

Becker's 11th annual IT and Revenue Cycle Conference is built for the people doing that work. More than 2,500 executive level attendees, 600 plus speakers, and four days of sessions designed around the real operational questions behind AI, cybersecurity, revenue cycle performance, and digital health. Join us September 14th through the 17th.

For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right. This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled to visit with Jakob Emerson. Jakob covers at Becker's Healthcare the payer arena and does so better than anybody else in the country. And so many interesting things going on in the payer area. Jakob, let me tee it up and ask you to take it away.

What are a couple of stories that you're watching closely in the payer industry currently? I'll ask you to take it away. Yeah. Hey, Scott. Good to talk with you. So I thought two stories we could touch on today that kind of encompass broader trends. The team has been covering, honestly, for a few years now here at Becker's.

One is a commentary from UnitedHealthcare's CEO on this AI billing war that we've been seeing going on for, I'd say, the better part of at least two years now between, well, in terms of what we cover, large health systems and insurance companies, both using their...

Medicare Advantage Litigation and the AI Battle Between Payers and Providers with Jakob Emerson

Read the full transcript

The candid version is on a podcast,
not the earnings call.

Medicare Advantage Litigation and the AI Battle Between Payers and Providers with Jakob Emerson

Read the full transcript

The candid version is on a podcast, not the earnings call.

The candid version is on a podcast,
not the earnings call.