Today's Top 20 Stories
  1. Blue Shield of California puts $464M on the line with state contract

    The California Public Employees’ Retirement System awarded its PPO contract to Blue Shield of California, the first time the contract has changed hands in 20 years. 
  2. The policies states want to keep after Medicaid redeterminations

    The majority of state Medicaid directors want to keep some of the temporary flexibilities CMS introduced during the redeterminations process, according to KFF. 
  3. Medicare Advantage in the headlines: 8 recent updates

    CMS will recalculate Medicare Advantage plans' 2024 star ratings, which could net some insurers millions more in bonus payments. 

The state of AI in healthcare

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  1. Cigna names chief accounting officer 

    The Cigna Group has promoted Jamie Kates to chief accounting officer, effective July 1.
  2. US uninsured rate to increase over next decade: CBO

    The U.S. uninsured rate is projected to increase to 8.9% by 2034, according to new estimates published by the Congressional Budget Office in June.
  3. UnitedHealthcare to pay $1M to New York for failing to cover contraceptives

    UnitedHealthcare of New York will pay $1 million to settle allegations it failed to cover contraceptives as required by state law. 
  4. SelectHealth opens Nevada headquarters

    Select Health has opened its Nevada headquarters in Las Vegas. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. 10 states where Medicaid redeterminations will continue past June

    A total of 40 states will complete the Medicaid redetermination process by June 2024, while a few are expected to continue into the second half of the year and beyond. 
  2. Texas payer warns of closure amid new state Medicaid contracts

    Driscoll Health Plan is warning about its future ability to remain operational following Texas' decision not to award the payer a Medicaid contract earlier this year.
  3. Optum, BCBS back $25M investment in AI prior authorization startup

    Humata Health, a company that uses AI and machine learning to streamline prior authorization for payers and providers, has closed a $25 million investment. 
  4. 7 state, federal health plan contract shakeups

    State health plan contracts, which provide coverage to thousands of employees and their dependents, can be worth hundreds of millions a year.  

How one Midwest hospital is driving financial efficiency with interconnected systems

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Major time savers can stem from single logins. That's how 1 hospital achieved a 50% reduction in month-end close time — read the short case study, here.
  1. 3 key questions for the future of the individual market

    2024 marks the 10th year ACA exchange plans are available to individuals. Enhanced government subsidies have prompted more people to enroll, and some payers are hoping more small- and medium-sized employers will opt to send their employees to the individual market. 
  2. Priority Health to purchase Indiana payer 

    Priority Health is planning to purchase Physicians Health Plan of Northern Indiana, a Fort Wayne-based payer with more than 52,000 members in Indiana and Ohio.
  3. Sanders calls out 3 payers over birth control coverage, urges investigation

    Sen. Bernie Sanders is asking the Government Accountability Office to investigate why some payers are charging members for birth control, which violates the ACA.
  4. Most valuable payer brands | 2024

    UnitedHealthcare's brand is worth more than $47 billion, according to estimates from Brand Finance. 
  5. US uninsured population drops to 25 million

    In 2023, 25 million people in the U.S. had no health insurance, according to a preliminary survey published in June by the National Center for Health Statistics.
  6. Former Aetna CEO dies at 93

    William Donaldson, who led Aetna for an influential 13 months, died June 12 at age 93. 
  7. MedPAC suggests ways to close Medicare Advantage data gap

    Data Medicare Advantage insurers provide to the federal government has become more complete in recent years, but gaps remain, according to MedPAC's annual report, titled "Medicare and the Health Care Delivery System." 
  8. Ascension's ACA plans also disrupted by cyberattack

    Ascension saw disruptions to its ACA health plans following the May cyberattack on the 140-hospital system, NPR reported June 14.
  9. 5 prior authorization updates

    From AMA priorities to new legislation, here are five updates on prior authorization Becker's has reported since May 28:

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