Today's Top 20 Stories
  1. BCBS Association: Postpartum complications more common in Black, Latina women

    Serious complications from birth often emerge weeks postpartum, according to a report published by the Blue Cross Blue Shield Association on June 11. 
  2. Why this Medicare Advantage CEO wants a Medicare 'reboot'

    "Misplaced nostalgia" for traditional Medicare will not solve the program's problems, SCAN Health Group CEO Sachin Jain, MD, wrote in Forbes on June 10. 
  3. UnitedHealth Group in the headlines: 10 updates

    Here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since May 28:

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  1. Elevance Health gets partial victory in star ratings lawsuit

    CMS must recalculate the Medicare Advantage star ratings for Anthem Blue Cross Blue Shield of Georgia, a federal judge ruled June 10. 
  2. Why 2 New York insurers plan to merge

    A planned merger between Capital District Physicians Health Plan and The Lifetime Healthcare Co. will allow the insurers to beef up their scale and investments in technology, executives say. 
  3. Medicare Advantage members spend over $2,500 less than traditional Medicare enrollees annually: Study 

    Medicare Advantage enrollees spend more than $2,500 less on healthcare costs on average than traditional Medicare enrollees, according to an independent analysis by ATI Advisory.
  4. Texas rejects insurers' Medicaid contract protests

    Texas officials rejected protests from eight insurers challenging its Medicaid contract awards. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Humana's Medicare Advantage clawback lawsuit to move forward, judge rules

    Humana's challenge to a CMS rule implementing stricter auditing standards on Medicare Advantage plans can continue, a federal judge ruled. 
  2. Baylor Scott & White, BCBS Texas facing July 1 split

    Dallas-based Baylor Scott & White Health and Blue Cross and Blue Shield of Texas will be out of network on July 1 without a new contract in place.
  3. Medicare Advantage in the headlines: 5 recent updates

    Courts sided with SCAN Health Plan in a star ratings lawsuit that could have implications for other plans, and a Blue Cross Blue Shield company is pulling out of the Medicare Advantage business. 
  4. Oscar Health plans to double its membership: 5 things to know

    Oscar Health wants to reach 4 million members by 2027. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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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. How payers can lead on women's health

    Payers can play a key role as educators, helping employers promote women's health, according to Mass General Brigham Health Plan's chief medical officer. 
  2. Optum sells Settlement Solutions business

    Optum has sold its workers' compensation Settlement Solutions business to ExamWorks Compliance Solutions, an Optum spokesperson told Becker's June 10.
  3. 5 recent payer investments in affordable housing

    Insurers are investing billions into affordable housing as they look to address healthcare challenges stemming from housing instability.
  4. Payers are missing major AI opportunities: McKinsey

    Artificial intelligence has the potential to lower internal and member costs for insurers while also increasing profits, but the industry has largely not embraced these opportunities, according to a June 5 analysis from McKinsey.
  5. Former UnitedHealth Group exec joins VSP Vision

    VSP Vision has named former UnitedHealth Group executive Usha Patil as chief insurance officer. 
  6. UnitedHealthcare, Alabama's largest private health system split

    Mobile, Ala.-based Infirmary Health is out of network with UnitedHealthcare as of June 4. 
  7. D-SNP prior auth denial rates twice as high as all Medicare Advantage

    Dual-eligible special needs plan enrollees are twice as likely to have prior authorization requests denied compared to all other Medicare Advantage members, according to KFF.
  8. California to repay $52M spent on Medicaid for noncitizens

    California improperly used $52.7 million in federal Medicaid funds to pay for nonemergency care for Medicaid recipients without legal status, according to an audit from HHS' Office of Inspector General. 
  9. Where payers landed on the Fortune 500 | 2024

    Seven payers landed among the top 25 healthcare companies on the Fortune 500 in 2024. 

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