Today's Top 20 Stories

  1. This Medicare Advantage plan says headwinds have 'very little impact'

    Rylee Wilson -
    Clover Health does not have direct competitors, CFO Peter Kuipers says. 

  2. What these payers learned through collaborating with their competitors

    Rylee Wilson -
    The largest payers in Washington state are working together to improve primary care. 

  3. Alabama state health plan warns of funding shortfall

    Jakob Emerson -
    Alabama's state employee health plan is facing a projected loss of about $20 million in fiscal year 2025, the Alabama Reflector reported Aug. 22.

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  1. BCBS Minnesota must face ERISA lawsuit from Labor Department, judge rules

    Jakob Emerson -
    A federal judge has ruled that Blue Cross and Blue Shield of Minnesota must face a lawsuit from the U.S. Labor Department accusing the payer of incorrectly imposing a state provider tax on self-funded health plan customers and violating its fiduciary duties under ERISA.

  2. Cigna names California market leader

    Rylee Wilson -
    Cigna Healthcare has promoted Marlene Matsuoka to general manager for its group employer business in Northern California. 

  3. Arizona upholds contract awards to UnitedHealth, Centene

    Rylee Wilson -
    Editor's note: This story was updated Sept. 12 to reflect that the Arizona Health Care Cost Containment Systems upheld its original contract awards.  Arizona will uphold contracts awarded to UnitedHealth and Centene to manage the state's long-term care Medicaid program. 

  4. Employers are worried about GLP-1s — most cover them anyway

    Rylee Wilson -
    Two-thirds of employers surveyed by the Business Group on Health cover GLP-1 drugs to treat obesity. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. How Congress members get their health insurance

    Rylee Wilson -
    Members of Congress are tasked with making decisions about the future of the ACA exchange — and they also receive their healthcare benefits through it. 

  2. 17 payers cutting jobs | 2024

    Jakob Emerson -
    Payers are trimming their workforces and cutting jobs due to financial or operational challenges, along with restructuring strategies. 

  3. OIG: Elevance subsidiary received $59M in Medicare Advantage overpayments 

    Jakob Emerson -
    MMM Healthcare, a Puerto Rico subsidiary of Elevance Health, received $59 million in net Medicare Advantage overpayments for 2017, according to an audit from HHS' Office of Inspector General published Aug. 14.

  4. 10 states reforming prior authorization in 2024

    Andrew Cass -
    Ten states have passed laws reforming the prior authorization process, according to an Aug. 19 report from the American Medical Association. 

How one Midwest hospital is driving financial efficiency with interconnected systems

Sponsored
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. Molina extends CEO's contract

    Andrew Cass -
    Molina Healthcare has amended the contract of president and CEO Joe Zubretsky with the aim of keeping him at the payer through at least the end of 2027. 

  2. The best insurer to work for in every state, per Forbes | 2024

    Rylee Wilson -
    Several insurers landed on Forbes' annual ranking of the "Best Employers by State." 

  3. Lowest-rated Medicare Advantage plans in 2024: J.D. Power

    Rylee Wilson -
    Medicare Advantage plans from Centene, Humana and UnitedHealthcare are among the lowest-rated plans for customer satisfaction in their markets in 2024, according to J.D. Power's annual Medicare Advantage Study.

  4. Nevada system terminates contract with UnitedHealthcare

    Jakob Emerson -
    Carson City, Nev.-based Carson Tahoe Health has sent a final contract termination notice to UnitedHealthcare. 

  5. BCBS Michigan lays off 64

    Rylee Wilson -
    Blue Cross Blue Shield of Michigan has laid off 64 employees as part of an effort to cut administrative expenses as medical costs rise. 

  6. 10 providers seeking payer contracting talent

    Andrew Cass -
    Ten providers recently posted job listings seeking leaders in payer contracting and relations.

  7. Top Medicare Advantage plans for member satisfaction in 2024: J.D. Power

    Rylee Wilson -
    UPMC has the highest-ranked Medicare Advantage plan for customer satisfaction in 2024, according to J.D. Power's latest annual Medicare Advantage Study. 

  8. California prior authorization bill clears legislative hurdle

    Andrew Cass -
    A California bill aiming to reform prior authorization cleared one of the final hurdles for bills making their way to the governor's desk, according to the California Medical Association. 

  9. 3 things payers need for great MA star ratings in 2025 and beyond: McKinsey

    Rylee Wilson -
    Star ratings are an increasingly important factor in which plans Medicare Advantage beneficiaries choose, according to McKinsey and Company. 

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