Today's Top 20 Stories
  1. McKinsey's predictions for payers in the next 3 years: 6 things to know

    While increased utilization and labor costs will be short-term challenges for payers, profits will continue to grow through 2026, according to an analysis from McKinsey published Jan. 9. 
  2. BCBS spinout launches revamped behavioral health platform

    Behavioral health management companies New Directions Behavioral Health and Tridium are combining under the name Lucet to offer a care navigation system for payers. 
  3. Half of patients with high-deductible health plans have received a surprise medical bill

    Half of patients with high-deductible health plans said they have received a surprise medical bill, according to a survey from Akasa, a revenue cycle firm that uses artificial intelligence.

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  1. Payers spent about the same for telehealth or in-person visits in 2020

    Insurers paid similar rates for telehealth and in-person services in 2020, according to an analysis from the Peterson-Kaiser Family Foundation Health System Tracker. 
  2. 35,000 enrolled in Colorado's public option in its first year

    Around 35,000 people have signed up for Colorado's public option, representing around 13 percent of the total ACA exchange enrollment in the state. 
  3. Meet America's largest employer of physicians: UnitedHealth Group

    The largest employer of physicians in the United States is not HCA, the VA, or Kaiser Permanente — it's UnitedHealth Group's Optum.
  4. Optum in the headlines: 7 recent updates

    UnitedHealth Group's health services division, Optum, has scored contracts to manage health systems' revenue cycle operations and is expecting double-digit revenue growth in 2023. 

Becker's Payer Issues Rountable

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  1. How payers stack up on work-life balance, employee benefits

    Elevance Health scored the top spot in the healthcare industry for employee benefits and work-life balance, according to Just Capital's ranking of the "most just" companies. 
  2. The uninsured rate grew during the pandemic in these 7 states

    The uninsured rate fell by .7 percent nationwide between 2019 and 2021, according to HHS data. While uninsured rates declined in most places, in seven states and the District of Columbia, rates increased slightly during the pandemic. 
  3. Medicare Advantage enrollment hits record 30 million

    Over 30 million people are now enrolled in Medicare Advantage plans, according to CMS data released Jan. 17.
  4. Evernorth names Express Scripts president

    Cigna's health services arm Evernorth has named Adam Kautzner, PharmD, president of Express Scripts, its pharmacy benefit manager. 

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  1. Amid insurance fight, some California hospital staff lose health coverage at their own facilities

    More than two weeks after Clovis, Calif.-based Community Health System went out of network with several major insurers, hospital staff members are speaking out after being left without covered access to the system's facilities.
  2. SCAN Group names Medicare president

    SCAN Group has promoted Karen Schulte to president of Medicare.
  3. Cigna's chief counsel departs for online insurance marketplace

    Cigna's top lawyer, Julia Brncic, is departing to become general counsel at EverQuote, an online insurance marketplace. 
  4. UnitedHealthcare, Temple University Health System approaching split date

    UnitedHealthcare is planning to terminate its Medicaid managed care contract with Philadelphia-based Temple University Health System on Feb. 1 if the sides are unable to strike a new deal, the Philadelphia Business Journal reported Jan. 17.  
  5. ACO REACH expanding in 2023

    Over 700,000 providers and organizations are participating in one of CMS' three accountable-care programs in 2023, the agency said Jan. 17. 
  6. Highmark Wholecare boosts Medicaid membership by over 70,000

    Highmark Wholecare has increased its Medicaid membership by nearly 25 percent since August, growing to more than 375,000 members. 
  7. 9 payer workforce updates

    Payers are shuffling office spaces and investing in programs to train new employees. Here are nine payer workforce developments Becker's has reported since Dec. 7. 
  8. States eye increased Medicaid reimbursement rates to retain behavioral health providers

    At least 28 states increased Medicaid reimbursement rates for behavioral health services in 2022, or plan to in 2023, according to a report from Kaiser Family Foundation. 
  9. Surgeon general hopeful for prior authorization changes

    Surgeon General Vivek Murthy, MD, said the stories he heard from clinicians in a recent listening session about the challenges prior authorizations pose were "deeply touching and I'd say disturbing as well."

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