Becker's Payer Issues | Payer News

The Blue Cross Blue Shield Association has named five senior leaders to roles spanning technology, policy, operations and communications. 1. Mouli Venkatesan, chief information and technology officer. Mr. Venkatesan will oversee BCBSA’s IT infrastructure, technology modernization and AI deployment. He…

CommonSpirit Health’s Tennessee and Georgia facilities (formerly CHI Memorial), went out of network with Cigna Healthcare on Feb. 1.  The network split affects individuals covered by Cigna’s commercial Open Access Plus PPO and its narrower-network Local Plus plan. The affected…

Oakland, Calif.-based Kaiser Permanente and Reno, Nev.-based Renown Health have finalized a joint venture to launch a new outpatient care delivery system and co-own a health plan in northern Nevada.  Five things to know:  1. Hometown Health, the health plan…

Accountable alternative payment models held steady in 2024, according to a Feb. 2 survey by America’s Health Insurance Plans. In 2024, 44.9% of healthcare payments stemmed from alternative payment models that ensure provider accountability for quality and cost of care.…

Humana is launching AI-enabled Agent Assist in collaboration with Google Cloud, according to a Feb. 3 news release. Agent Assist aims to personalize and expedite member support by generating real-time conversation summaries, predicting member needs and contributing relevant information efficiently…

Medicaid expansion campaign Florida Decides Healthcare relaunched efforts to collect signatures, now for the 2028 ballot, according to a Feb. 1 news release shared with Becker’s. The proposed amendment would boost Medicaid eligibility for those between ages 18 and 64…

Clever Care Health Plan ushered in almost 15,000 new Medicare Advantage members — membership growth of nearly 50% — during the 2026 Medicare annual enrollment period, according to a Feb. 3 news release from the company. Clever Care offers what…

Melissa Mohon — executive director of compliance, privacy and regulatory affairs for Baltimore-based Johns Hopkins Health Plans — was chosen to chair the Medicare Advantage Plan Alliance Compliance Forum, according to a Feb. 2 news release. As chair, Ms. Mohon…

Aetna has named COO Katerina Guerraz as president of its Medicaid division. She will continue serving as chief operating officer. “This expanded responsibility is an opportunity to further strengthen our mission by deepening our focus on serving Medicaid members –…

Elevance Health is suing four former executives of its Puerto Rico subsidiary, alleging they violated noncompete agreements by leaving for rival insurer Triple-S Salud. The complaint, filed Jan. 29 in an Indiana federal court, claims the former executives broke the…