Today's Top 20 Stories

  1. Medicare Advantage penetration by state | 2024

    Jakob Emerson -
    In 2024, 32.8 million people are enrolled in Medicare Advantage, or 54% of the eligible Medicare population.

  2. BCBS Massachusetts names SVP of government programs

    Rylee Wilson -
    Blue Cross Blue Shield of Massachusetts has named Krista Bowers as senior vice president of government programs. 

  3. UnitedHealthcare embraces consumerism

    Jakob Emerson -
    The consumerization of healthcare is accelerating, and the nation's largest health insurer is keeping pace.

Becker's Fall Payer Issues Roundtable

Sponsored
Becker's is gathering 500+ payer execs in Chicago this fall. Learn how your company can join them — here.

  1. Is the two-midnight rule costing payers? It depends who you ask

    Rylee Wilson -
    Both CVS Health and Humana contend with rising inpatient costs in Medicare Advantage, but each points to different causes for the increases. 

  2. Payers ranked by Medicaid losses

    Jakob Emerson -
    Medicaid redeterminations began in April 2023, and all major payers have released their second quarter 2024 earnings, revealing which have recorded the largest enrollment losses in the Medicaid market since redeterminations began.

  3. California payer cuts 24% of prior authorization requirements

    Rylee Wilson -
    L.A. Care Health Plan has removed 24% of its prior authorization requirements. 

  4. GuideWell closing clinics, laying off 245

    Jakob Emerson -
    GuideWell is shuttering Diagnostic Clinic Medical Group, a chain of four medical clinics offering primary and specialty care, imaging, and physical therapy.

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. These 16 states cover weight loss drugs for their employees

    Rylee Wilson -
    At least 16 states provide coverage of GLP-1 drugs for weight loss to state employees, according to data from Leverage and the Robert Wood Johnson Foundation. 

  2. CVS: Second half of 2024 could be even worse for Medicare Advantage

    Rylee Wilson -
    Medicare Advantage costs could rise in the second half of 2024, CVS Health CFO Tom Cowhey told investors. 

  3. Payers pledge defense of their PBMs

    Rylee Wilson -
    Payers are preparing an aggressive defense of their pharmaceutical benefit managers from scrutiny on Capitol Hill. 

  4. North Carolina state health plan faces possible insolvency

    Jakob Emerson -
    North Carolina's Treasurer Dale Folwell is warning that the state health plan could soon be facing insolvency.

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. Elevance's global CIO departs

    Jakob Emerson -
    Elevance Health's global chief information officer, Anil Bhatt, is leaving the company after 16 years.

  2. Aetna president out after disappointing financial results

    Rylee Wilson -
    CVS Health CEO Karen Lynch will take over leadership of Aetna after a difficult year for the insurer. 

  3. BCBS Louisiana rebrands

    Rylee Wilson -
    Blue Cross Blue Shield of Louisiana will rebrand as Louisiana Blue. 

  4. Clover Health turns 1st profit

    Rylee Wilson -
    Clover Health reported a net income of $7.2 million in the second quarter of 2024, the company's first-ever profitable quarter. 

  5. Medicare Advantage insurers ranked by prior authorization denial rates

    Rylee Wilson -
    Medicare Advantage insurers denied 7.4% of prior authorization requests in 2022, according to data published by KFF. 

  6. After hitting record low, uninsured rates climb: CDC

    Rylee Wilson -
    After hitting record lows in 2023, uninsured rates are beginning to rise again, according to new CDC data. 

  7. Where payers landed on Fortune's Global 500 | 2024

    Rylee Wilson -
    UnitedHealth Group and CVS Health are among the 10 largest companies in the world, according to Fortune's Global 500. 

  8. Weight loss drugs 1 factor behind ACA premium increases: 3 things to know

    Rylee Wilson -
    Premiums for plans on the ACA marketplace will rise 7% on average in 2025, according to an analysis from Peterson-KFF Health System Tracker published Aug. 5. 

  9. UnitedHealth sues Minnesota over law banning for-profit Medicaid insurers

    Rylee Wilson -
    UnitedHealth Group is suing the state of Minnesota over a law that bans for-profit Medicaid managed-care providers from participating in the state's Medicaid program. 

Featured Learning Opportunities

Top 40 articles from the past 6 months