Common medical procedures can cost more than twice as much when they take place in a hospital outpatient setting compared to a physician office or ambulatory surgery center, according to an analysis published Sept. 14 by the Blue Cross Blue Shield Association.

Mike Murphy, one of the longest-serving Blue Cross Blue Shield CEOs, says relationships with providers have not worsened over his 16 years at the helm of Anthem BCBS Nevada — they've just grown more complicated. 

CVS Health CEO Karen Lynch said she is "optimistic" Aetna will improve its Medicare Advantage star ratings for 2024. 

Some payers are reporting big savings with value-based care efforts. 

There is a small pool of executive candidates who can oversee millions of lives and produce positive financial results for large healthcare organizations, and payers have shown they are willing to take those executives to court when they leave for new opportunities.

Corvallis, Ore.-based Samaritan Health Services has terminated its commercial and Medicare Advantage contracts with UnitedHealthcare.

Reactions to Blue Shield of California's decision to drop its contract with CVS Caremark to manage pharmacy benefits in favor of a partnership with five companies have been overblown, CVS Health CEO Karen Lynch said. 

The nation's largest Latino civil rights organization, UnidosUS, along with 12 other state and national organizations, have filed a complaint with the HHS Office of Civil Rights regarding what they say is Florida's "illegal discrimination" under the Civil Rights Act against families and children of color amid the state's Medicaid redetermination process.

Over 1,000 Blue Cross Blue Shield of Michigan employees are striking, after United Auto Workers and the company failed to reach a new contract agreement. 

Weight loss drugs like Ozempic and other GLP-1s exploded in popularity this year, resulting in drug shortages and increasing costs for payers and employers. 

CVS Health recently expanded the roles of three of its C-suite executives and welcomed a new president of Aetna. Here is more information about executives that make up CVS Health's leadership team, according to the company's website:  

Additional Medicaid coverage enacted during the COVID-19 pandemic helped keep the number of uninsured people down at record lows in 2022 even as poverty levels soared, according to a Sept. 12 New York Times report.

From payers announcing cuts, to a lawmaker investigation denials, here are five updates about prior authorizations Becker's reported since Aug. 17: 

Seven payers, including UnitedHealthcare, Molina Healthcare and Centene subsidiary SuperiorHealth Plan, were awarded contracts to manage Texas' STAR +PLUS program, which provides Medicaid to adults with disabilities or are 65 years of age and older. 

Mississippi could consider Medicaid expansion next year, Mississippi Rep. Jason White told Mississippi Today. 

The majority of older adults say they would stick with their current Medicare plan rather than switch to a different plan when they feel they have too many options, a survey from the Commonwealth Fund found. 

Humana offers the best Medicare supplement plan in 2023, according to a ranking published Sept. 7 by Forbes Health.

Humana, Aetna and Molina are not renewing their contracts with senior companionship company Papa following allegations of abuse against patients or company employees, Bloomberg reported Sept. 11.

Empire BlueCross BlueShield and Rockville Centre, N.Y.-based Catholic Health have partnered on a multi-year value-based payment and care delivery model.

Elevance Health is seeking to block a former regional Medicare president from taking a similar role at Molina Healthcare, alleging the former executive is in possession of trade secrets that would inevitably be disclosed to Molina.