Today's Top 20 Stories
  1. What 5 payer leaders said about GLP-1 drugs

    New GLP-1 drugs to treat Type 2 diabetes and obesity can be expensive, but payer leaders said the costs aren't breaking the bank yet. 
  2. More research needed on Medicare Advantage care quality, Mount Sinai researchers say

    More data is necessary to evaluate the quality of care Medicare Advantage beneficiaries with serious illnesses receive, a group of researchers wrote in the New England Journal of Medicine. 
  3. Former Aetna executive named Healthy Blue Kansas president

    Bryan Baier has been named president of Healthy Blue Kansas — a collaboration between Blue Cross and Blue Shield of Kansas and Blue Shield of Kansas City.

Target the full spectrum of cardiometabolic conditions for better member outcomes, plan savings

Only 2.7% of US adults live a healthy lifestyle — & that costs health plans $500B a year. This approach supports better outcomes + employer savings.
  1. How will AI change the payer industry? 18 leaders explain

    Payers are putting artificial intelligence to work. 
  2. Payers ranked by Q1 membership growth

    Cigna posted the largest membership growth of prominent payer companies in the first quarter of 2023. 
  3. BCBS Minnesota, North Memorial Health end joint clinic ownership venture

    Blue Cross and Blue Shield of Minnesota and Robbinsdale, Minn.-based North Memorial Health will end joint ownership of 25 primary, specialty and hospice care clinics. 
  4. Employers not ready to cover new weight-loss drugs, Cigna CEO says

    Employers are hesitant to cover the cost of GLP-1 drugs for their employees, the Cigna Group CEO David Cordani said. 

3 ways to address No Surprises Act compliance challenges

A no-surprises approach to the No Surprises Act — get 3 strategies to improve compliance here.
  1. Humana in the headlines: 8 updates

    From the release of its first-quarter earnings, to launching new Medicare Advantage special needs plans, here are eight updates about Humana that Becker's has reported since April 20:
  2. The potential cost of federal Medicaid work requirements, state by state

    Federal Medicaid work requirements could cost states up to $10.3 billion each year if they chose to maintain coverage for people no longer federally eligible for the program, according to an analysis from Kaiser Family Foundation. 
  3. UnitedHealthcare, Phoenix Children's at impasse as contract end date nears

    Phoenix Children's will go out of network with UnitedHealthcare on June 1 if the sides are unable to reach an agreement on a new contract. 
  4. Alignment Healthcare posts $37.4M loss in Q1

    Alignment Healthcare upped its year-over-year revenue and improved on losses in the first quarter of 2023. 

Target the full spectrum of cardiometabolic conditions for better member outcomes, plan savings

Only 2.7% of US adults live a healthy lifestyle — & that costs health plans $500B a year. This approach supports better outcomes + employer savings.
  1. Blue Shield of California posts $910M loss in 2022

    Blue Shield of California lost $910 million in 2022 as medical costs rose, according to the company's 2022 annual report. 
  2. Big payers ranked by Q1 profit

    The nation's largest payers have filed their first-quarter earnings reports, detailing revenue and profit totals. Becker's analyzed financial earnings at each company as a whole, along with their individual health benefits segments.
  3. Medicare improperly paid for $580M in psychotherapy services, OIG audit finds

    Medicare improperly paid for over half a billion dollars in psychotherapy services, including telehealth, during the first year of the COVID-19 pandemic, an audit from HHS' Office of Inspector General found. 
  4. Cigna posts $1.3B profit in Q1

    The Cigna Group beat investor expectations and reported a 10 percent growth in membership year over year, according to the company's first quarter earnings published May 5.
  5. Arizona was among the 1st states to terminate Medicaid coverage. Here's how BCBS is supporting members through it

    As Medicaid redeterminations take place nationwide, some states have been terminating coverage for more than a month, including Arizona.
  6. Maryland expands Medicaid coverage for gender-affirming care

    Maryland Gov. Wes Moore on May 3 signed a bill into law that will expand Medicaid coverage for gender-affirming treatments. 
  7. Minnesota orders payer to cease all operations

    Minnesota has ordered Salvasen Health to cease all operations in the state and fined the company $553,000 for selling unapproved health plans without a license.
  8. Health Net, L.A. Care Health Plan put $114M behind homelessness initiatives

    L.A. Care Health Plan and Health Net said May 3 they are investing $114 million into initiatives aimed at addressing homelessness and housing insecurity as social determinants of health in Los Angeles County.
  9. Regence BCBS Utah names executive medical director

    Regence BlueCross BlueShield of Utah has named Anthony Dowidowicz, MD, as executive medical director. 

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