Today's Top 20 Stories
  1. 10 providers seeking payer contracting talent

    Ten providers — including HCA Healthcare and Orlando Health — recently posted job listings seeking leaders in payer contracting and relations.
  2. UnitedHealthcare to issue final updated fee schedule mailing

    About 8,000 contracted providers will begin receiving notices Dec. 1 that UnitedHealthcare is moving them to a new fee schedule, according to the California Medical Association. 
  3. Where 8 payers are spending their investment dollars

    From CVS Health and Centene to several BCBS affiliates, this is where eight payer venture arms have recently invested:

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  1. Data is key: How Health Net approaches health equity

    Health Net, a subsidiary of Centene, serves more than 3 million California Medicaid, or Medi-Cal members.
  2. Independence Blue Cross: stop using such complicated insurance language

    Payers, along with healthcare organizations in general, should refrain from using complicated industry-speak in communications with members because it creates confusion and inequities, according to Independence Blue Cross' communications standards lead, Matthew Jakubowski.
  3. UnitedHealthcare in the headlines: 14 recent updates

    UnitedHealth Group is adding new partnerships and striking contract deals, while its mergers and acquisitions continue to make the news. 
  4. Cities with the least competitive commercial insurance markets

    Alabama has some of the most concentrated commercial insurance markets in the country, according to a report from the American Medical Association. 

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  1. UnitedHealthcare to providers: Expect more members as Bright, Friday Health exit ACA markets

    UnitedHealthcare is preparing for more members to join its ACA plans after Bright Health and Friday Health Plans have exited individual insurance markets in several states. 
  2. Highmark, Kaleida Health sign long-term network contract

    Highmark Blue Cross Blue Shield of Western New York and Buffalo-based Kaleida Health have signed a long-term agreement to allow Highmark’s members to have in-network access to Kaleida's facilities.
  3. Highmark BCBS West Virginia names Medicaid president 

    Highmark Blue Cross Blue Shield West Virginia has named Jason Landers as president of its West Virginia Medicaid business, Highmark Health Options.
  4. 5 major Centene deals in 2022

    Centene announced Nov. 17 it is selling Magellan Specialty Health, the latest in a number of deals the health insurer has made throughout 2022. 

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  1. Newly released Medicare Advantage audits show some plans overbilled upward of $1K per patient each year

    Newly released audits show Medicare Advantage plans overbilled the federal government by millions between 2011 and 2013, with some plans overbilling an average of more than $1,000 per patient per year, Kaiser Health News reported Nov. 21. 
  2. Georgia set to become only state with Medicaid work requirement

    Georgia is moving forward with a limited Medicaid expansion plan that includes work requirements, Capitol Beat News Service reported Nov. 18.
  3. ACA enrollments up 40% from last year, Biden says

    Enrollment in ACA exchange plans is up 40 percent from this time last year, President Joe Biden said in remarks to business and labor leaders on Nov. 18. 
  4. The largest exchange plan payer in every state

    Centene holds the largest share of the ACA exchange market in the U.S., at 15 percent, according to a study from the American Medical Association. 
  5. How payers compare on Medicare Advantage nutrition benefits

    Over 70 percent of Medicare Advantage members receive meal benefits as part of their plan, according to an analysis from Kaiser Family Foundation. 
  6. 5 startups payers are investing in

    Here are five startups that have received backing from payers this year: 
  7. Centene completes sale of Spanish, central European businesses

    Centene said in a Nov. 17 news release it has completed the sale of its Spanish and central European businesses to Vivalto Santé, a French private hospital group. 
  8. Medicare Advantage in the headlines: 15 updates to know

    Medicare Advantage open enrollment is underway, and plans are adding more services for members. Some plans have expanded geographic areas, while others have pulled out of markets. 
  9. 20 recent payer CEO moves

    From BCBS Massachusetts to UnitedHealthcare's California market, these are 20 payer CEO moves recently reported by Becker's:

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