Becker's Payer Issues | Payer News

With a joint venture finalized, Reno, Nev.-based Renown Health and Oakland, Calif.-based Kaiser Permanente now co-own Renown’s health plan, Hometown Health.  For Kaiser, it marks its entry into Nevada. For Renown, it’s an opportunity to scale up its health plan…

Cost Plus Drugs co-founder Mark Cuban is not convinced the Federal Trade Commission’s settlement with Cigna’s Express Scripts is going to amount to much. “My initial response to the FTC [and pharmacy benefit manager] settlements … meh. [G]reat intent. [W]ill…

Nearly one-third of physicians enrolled in Medicaid don’t treat patients covered by the program, according to a study published Feb. 2 in Health Affairs. A team led by researchers at Portland-based Oregon Health & Science University analyzed physician enrollment files…

CVS Health is cutting 313 positions in Aetna’s small group insurance business, according to regulatory documents filed Feb. 4 with the Connecticut Department of Labor. Most of the affected employees work remotely across multiple states but report to Aetna’s headquarters…

The acquisition of ASCs by UnitedHealth Group’s Optum, parent company of ASC chain SCA Health, was associated with double-digit price increases for competing insurers, according to a February study published in Health Affairs. The study examined Optum’s acquisitions of physician…

CMS is planning to continue its Medicare Advantage audits and overpayment recoveries, according to a Jan. 27 memo. While federal estimates point to $17 billion in overpayments each year, the last major risk-adjustment data-validation recovery took place in payment year…

The Cigna Group reported nearly $6 billion in profits in 2025, according to the company’s fourth quarter earnings report published Feb. 5. Total revenues in the fourth quarter were $72.5 billion, up 10% year over year. Total revenues in 2025…

KLAS Research, a healthcare IT data and insights company, released its annual “Best in KLAS” report Feb. 4.    Best in KLAS, now in its 28th year, draws on tens of thousands of provider evaluations to identify the top-performing solutions in…

Four studies involving Oakland, Calif.-based Kaiser Permanente, Arkansas BCBS and Independence Blue Cross identified total cost savings through psychiatric collaborative care models, according to reports from the Mental Health Treatment and Research Institute, and the Bowman Family Foundation. Health plan…

The California Department of Managed Health Care fined Centene’s Health Net plans $1.3 million over alleged “mishandling [of] provider payment disputes,” according to a Feb. 4 agency news release. California levied an $850,000 fine on Health Net Community Solutions and…