Today's Top 20 Stories
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OIG: 14 states paid managed care organizations $249M for deceased Medicaid enrollees
Fourteen states gave managed care organizations payments for Medicaid enrollees for months after beneficiaries had died, a series of HHS Office of Inspector General audits found. -
5 employer insurance trends to watch in 2024
Employers will be expecting insurers and vendors to deliver more transparency and ways to cut healthcare spending in 2024, according to the Business Group on Health. -
Optum's full-risk Medicare Advantage patients have better health outcomes than Medicare enrollees
Optum patients who are enrolled in fully accountable Medicare Advantage plans — where Optum takes full financial and clinical responsibility — have better health outcomes than patients enrolled in traditional Medicare, according to UnitedHealthcare CEO Brian Thompson.
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HCSC eyeing Cigna's Medicare Advantage business: Report
The sale of Cigna's Medicare Advantage business would remove one hurdle in the company's reported goal to merge with Humana, and Health Care Service Corp. might be part of that equation, Bloomberg reported Nov. 29. -
18 top execs that have recently left Optum
In 2023, 18 top executives previously with UnitedHealth Group's Optum have announced retirement or new positions with companies across the country. -
14 top execs that have recently left UnitedHealth Group
From regional CEOs to its chief growth officer, these are 14 top executives that have recently departed from UnitedHealth Group and its subsidiaries. -
Highmark Blue Shield names SVP of corporate affairs
Highmark Blue Shield has named Ken Lawrence as senior vice president of corporate affairs for southeastern Pennsylvania as the company expands its health plans into the Philadelphia area next year.
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UnitedHealth received 3.9M job applications in 2023
Nearly 4 million people applied to work at UnitedHealth Group in 2023, CEO Andrew Witty said. -
Former UnitedHealthcare, Optum executive joins Scene Health
Former UnitedHealthcare and Optum executive William Teague has joined medication engagement company Scene Health as vice president of population health and health plan strategy. -
Why BCBS Arizona wants to look more like Kaiser
Blue Cross Blue Shield of Arizona is looking to the payer-provider example set by Kaiser Permanente as the Phoenix-based company expands its primary care subsidiary Prosano Health Solutions, the Phoenix Business Journal reported Nov. 20. -
BCBS Michigan reaches tentative deal with workers after 11-week strike
Blue Cross Blue Shield of Michigan has reached a tentative agreement with over 1,000 employees on strike.
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Cigna, Humana 'in talks' to merge
The Cigna Group and Humana are "in talks" to merge, The Wall Street Journal reported Nov. 29. -
UnitedHealth's 5 growth priorities
UnitedHealth Group outlined its five strategic growth priorities at its annual investor conference Nov. 29: -
UnitedHealth Group projects $400B in 2024 revenue
UnitedHealth Group expects 2024 revenues to be at least $400 billion. -
Anthem, Wellstar agree to 4-year contract
Anthem Blue Cross and Blue Shield of Georgia and Marietta, Ga.-based Wellstar Health System have agreed to a new contract that will keep Wellstar patients in network with the payer through May 2027. -
UnitedHealthcare updates home health prior authorization review process
UnitedHealthcare is updating its prior authorization and concurrent review process for home health services that are delegated to Home & Community Care, the payer's home care division. -
20% of ACA marketplace enrollees are new to program: HHS
About 4.6 million people have signed up for health insurance through ACA marketplaces as of Nov. 18. -
UnitedHealth, Cigna face lawsuits over alleged automated claims denials
UnitedHealthcare and Cigna Healthcare are facing lawsuits from members or their families alleging the organizations use automated data tools to wrongfully deny members' medical claims. The allegations come amid broader ongoing conversations among policymakers around insurers' use of algorithms and artificial intelligence when processing claims or prior authorization requests. -
Bipartisan anger over Medicare Advantage denials on the rise
Concerns about Medicare Advantage denials are on the rise in Washington, Politico reported Nov. 24. -
BCBS Association taps CareFirst CEO as board chair
The Blue Cross Blue Shield Association's board of directors has elected CareFirst BlueCross BlueShield President and CEO Brian Pieninck as chair, effective Nov. 15.
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