Today's Top 20 Stories
  1. Health Care Service Corp. names Medicaid president

    Health Care Service Corp., the parent company of BCBS Texas, Illinois, New Mexico and Montana, has named Anne Rote president of its Medicaid division. 
  2. 3 payer CEOs among Fortune's '50 Most Powerful Women'

    Three payer CEOs were named to Fortune's 2022 "50 Most Powerful Women" list released Oct. 4. 
  3. Southwestern Health Resources, BCBS of Texas reach new contract

    Farmers Branch, Texas-based Southwestern Health Resources and Blue Cross and Blue Shield of Texas have reached a multiyear contract. 

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  1. 'The Blues Conspiracy': Federal court revives antitrust claims against BCBS Michigan over anesthesiology rates

    Blue Cross Blue Shield of Michigan is facing a revived antitrust lawsuit from the Anesthesia Associates of Ann Arbor over an alleged decadeslong scheme to control the state's anesthesia market.
  2. Where 8 payers are expanding Medicare Advantage in 2023

    With the Medicare annual enrollment period set to begin Oct. 15, payers nationwide are greatly expanding their Medicare Advantage plans to new states and hundreds of new counties in 2023.
  3. Meet the BCBS CEOs in the West

    Most of the nation's largest health payers have a single CEO at the helm and operate under one name across many states. In contrast, Blue Cross and Blue Shield payers function as smaller, independent companies, though they are often the largest insurer within their respective state.
  4. 7 payers join Hurricane Ian relief efforts

    Several healthcare payers have joined hurricane relief efforts, pledging philanthropic support to Florida communities recovering from Hurricane Ian. 

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  1. Medicare Advantage plans sending skilled-nursing patients home too soon, advocates say

    Providers, nursing home representatives and advocates for patients say Medicare Advantage plans are sending enrollees home from skilled nursing and rehabilitation centers before they are healthy enough to leave, according to an Oct. 3 Kaiser Health News and Fortune report. 
  2. Moda Health expanding to Idaho

    Moda Health, a Portland, Ore.-based insurer with 400,000 members, is offering plans in Idaho for 2023, the company said Oct. 3. 
  3. 7 recent payer mergers and acquisitions

    The largest healthcare merger of 2022 has been finalized between Optum and Change Healthcare, and CVS Health plans to acquire home health company Signify for $8 million. These are seven mergers and acquisitions reported by Becker's since Sept. 5:
  4. New York Medicaid Inspector General's Office recovered, saved $3.2B in 2021

    The New York Medicaid Inspector General's Office recovered and saved a combined $3.2 billion in 2021, up from $3 billion in 2020, according to the office's 2021 report.  

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  1. CVS Health inks deal to sell benefits administration platform Bswift

    CVS Health is selling benefits administration platform Bswift. Francisco Partners, a tech investment firm, said Oct. 3 it will acquire the company. 
  2. Health coverage losses during the pandemic disproportionately affected women, small business employees

    Enrollment in employer-sponsored health insurance declined during the COVID-19 pandemic, disproportionately affecting women and employees of small businesses, a new study published in JAMA Network Open found. 
  3. Adaptability and flexibility; 2 characteristics Paul Scaglione says will be essential in the upcoming years

    Paul Scaglione serves as the chief growth leader of Lake Forest, Ill.-based Trustmark Health Benefits. 
  4. OIG wants BCBS Tennessee, Inter Valley Health to refund millions in overpayments

    Audits of BlueCross BlueShield of Tennessee and Inter Valley Health Plan found the organizations' Medicare Advantage plans received millions in overpayments as a result of diagnosis codes submitted to CMS that were not backed up by medical records. 
  5. North Carolina provider Tryon drops Humana Medicare Advantage members

    Tryon Medical Partners, the largest independent primary care provider in the Charlotte, N.C.-area, is no longer in-network with Humana Medicare Advantage plans, NC Health News reported Oct. 3. 
  6. Molina finalizes $110M purchase of AgeWell New York's Medicaid managed care plan

    Molina Healthcare has finalized its acquisition of AgeWell New York's Medicaid managed long-term care business for $110 million.
  7. Medicare Advantage in the headlines: 14 stories to know

    From premium decreases and study findings to star ratings and plan expansions, here are 14 Medicare Advantage stories Becker's has reported since Sept. 12. 
  8. 18 payers to join CMS value-based Medicare Advantage model for 2023

    CMS' Value-Based Insurance Design program for Medicare Advantage plans is growing for 2023, expanding to 52 participating organizations, the agency said Sept. 29. 
  9. Senators push CMS on crisis stabilization center funding clarification

    A group of senators is asking CMS to clarify whether Medicaid funds can be used to pay for crisis stabilization in facilities with more than 16 beds.

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