Today's Top 20 Stories
  1. 9 states that could see more Medicare Advantage dollars in 2025

    Medicare Advantage beneficiaries in a few states could see increased supplemental benefits or reduced cost sharing in 2025, according to estimates from Berkeley Research Group. 
  2. Optum looks to fast-track Oregon clinic purchase amid solvency 'emergency'

    UnitedHealth Group's Optum is seeking to fast-track its proposed purchase of Corvallis (Ore.) Clinic, citing an urgent need to "maintain the solvency" of the physician-owned organization.
  3. Aetna, NewYork-Presbyterian 'far apart' as contract deadline nears

    New York City-based NewYork-Presbyterian could go out of network with Aetna if the sides are unable to reach a new contract agreement by March 31, The Journal News reported March 12. 

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  1. Why primary care may cost less in Medicare Advantage

    Selective contracting with primary care physicians may be one factor behind lower per-patient expenses in Medicare Advantage, a study published in the March edition of Health Affairs found. 
  2. Highmark lays off 182 employees

    Highmark has laid off 182 employees, a spokesperson for the company told Becker's March 11.
  3. Biden administration pitches 'Medicaid-like' coverage in nonexpansion states

    The Biden Administration is doubling down on a proposal to create "Medicaid-like" coverage for low-income adults in states that have not expanded the program. 
  4. How Elevance Health is improving health outcomes through an integrated spectrum of care

    The healthcare industry is rapidly evolving, transforming both patient experiences and healthcare delivery. It's essential to embrace an integrated spectrum of care, which encompasses in-person, digital, and virtual services to adapt to this changing landscape. This approach enables timely medical interventions, minimizes travel issues, ensures ongoing support, and ultimately results in better health outcomes.

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. 9 payer M&A updates

    From the Elevance-Blue Cross Blue Shield of Louisiana deal put on hold again to Cigna reaching a deal to sell its Medicare business, here are nine payer mergers and acquisitions updates Becker's has reported since Jan. 29: 
  2. A 'paradigm shift' in weight loss drug coverage

    Wegovy is now approved to be used to reduce the risk of heart attack, stroke and cardiovascular death, which could lead to broader payer coverage of the drug. 
  3. Elevance closes Paragon Health acquisition

    Elevance Health has closed the acquisition of infusion center and specialty pharmacy operator Paragon Healthcare. 
  4. HHS to UnitedHealth, payers: Help providers with cash flow following Change attack

    The federal government is urging UnitedHealth Group and other insurers to address cash flow issues among providers facing an absence of timely payments following the cyberattack on Change Healthcare in February.

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. Aetna, Humana, Elevance sign on to Biden's cancer coverage proposal

    Seven insurers have pledged to cover navigation services for cancer and other serious illnesses. 
  2. Part D plans ramp up prior authorization

    Medicare Part D plans have ramped up restrictions on prescription drugs since 2011, a study published in the March edition of Health Affairs found. 
  3. Fastest growing Medicare Advantage startup plans | 2024

    Enrollment in Medicare Advantage startup plans grew 18% from 2023 to 2024, according to a March 5 analysis from Chartis. 
  4. 5 things to know about Cigna's '1st of its kind' GLP-1 program

    The Cigna Group has launched EncircleRx, a program aimed at helping employers control the cost of GLP-1 drugs for weight-loss. 
  5. Former Humana exec named Clover Health Medicare Advantage CFO

    Clover Health has named Clay Thornton CFO of its Medicare Advantage division. 
  6. UnitedHealth details Change attack recovery timeline: 5 updates for payers

    UnitedHealth Group detailed a timeline March 7 for restoring key Change Healthcare systems following the unprecedented cyberattack on the company in late February. 
  7. Louisiana lawmakers look to make a future BCBS sale more difficult 

    Three weeks after a halted merger between BCBS Louisiana and Elevance Health, two Louisiana state lawmakers have filed bills that would make it more difficult for nonprofit insurers, (such as BCBS Louisiana) to reorganize into a for-profit organization that could then be sold, nola.com reported March 5.
  8. 3 BCBS companies reporting losses in 2023

    Some Blue Cross Blue Shield plans are reporting year-end financial losses due to ongoing trends such as rising utilization in the Medicare Advantage space and growing demand for weight loss drugs. 
  9. How 4 major payers have been affected by Change Healthcare attack

    Payers are reporting significant reductions in the volume of claims they receive from providers following the ransomware attack on Optum's Change Healthcare in late February, but the effect on prior authorization processes has been limited.

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