Today's Top 20 Stories
  1. 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. 
  2. 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.
  3. The 10 drugs most likely to be the 1st negotiated by Medicare

    The first drugs negotiated by Medicare are likely to be blood thinners, diabetes treatments and cancer drugs, physicians predicted in a Sept. 30 article for Health Affairs.

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  1. Florida Blue, Centene pledge millions to hurricane relief efforts

    Centene and Florida Blue are among the largest donors to Florida's disaster fund support recovery from Hurricane Ian, according to a news release from the state's first lady, Casey DeSantis. 
  2. Blue Cross and Blue Shield of Minnesota adding virtual culturally-sensitive care option

    Blue Cross and Blue Shield of Minnesota will provide 200 memberships to virtual culturally-sensitive care provider Health in Her Hue, the insurer said Sept. 30. 
  3. AHIP applauds Medicare Advantage premium decreases

    AHIP president and CEO Matt Eyles lauded CMS' announcement that average Medicare Advantage premiums will decrease in 2023, calling the price drop a "further demonstration" of the value of Medicare Advantage plans. 
  4. Southwestern Health Resources seeks $900M increase from BCBS Texas

    Farmers Branch, Texas-based Southwestern Health Resources is seeking a more than $900 million increase over the next 32 months in a new contract with Blue Cross Blue Shield of Texas, the Dallas Morning News reported Sept. 29. 

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  1. North Carolina delays launch of Medicaid managed care tailored plans

    The North Carolina Department of Health and Human Services is delaying the implementation of its Medicaid managed care behavioral health and intellectual/developmental disabilities tailored plans until April 1. 
  2. 9 new payer-provider contracts

    Here are nine contract updates Becker's has reported since Sept. 7. 
  3. Payers with the best telehealth services in 2022, per J.D. Power

    Among the major payers, customers are most satisfied with the telehealth offerings from Humana and Aetna, according to the "J.D. Power 2022 U.S. Telehealth Satisfaction Study."
  4. 7 payers receive first NCQA accreditation for health equity

    The National Committee for Quality Assurance has recognized nine healthcare organizations, including seven payers, for their work to address care inequities.

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  1. 20 payer exec moves in September

    From filling the top tech job at Optum to multiple former UnitedHealthcare CEOs headed to lead new companies, these are 20 payer exec moves reported by Becker's in September:
  2. Medicare Advantage premiums to decrease

    Medicare Advantage premiums will decrease for 2023, CMS said Sept. 29, continuing a trend in slight cost reductions for next year across Medicare services. 
  3. Cone Health, Novant Health finalize co-ownership of Medicare Advantage plan

    Cone Health and Novant Health have signed an agreement to co-own HealthTeam Advantage — a Medicare Advantage company owned by Cone Health, which will retain a majority stake.
  4. 'Very challenging': How focus group participants describe issues with Medicaid communication, enrollment

    Medicaid beneficiaries say communicating with the agency is difficult, and the reapplication process is confusing and cumbersome. 
  5. Icario launches Medicaid redetermination service

    Health consumer engagement company Icario is launching a Medicaid redetermination service, designed at streamlining the re-enrollment process with many Medicaid beneficiaries set to lose coverage when the COVID-19 public health emergency ends. 
  6. U of Arkansas graduate program named after retired BCBS executive

    A new master's program at the Fayetteville-based University of Arkansas has been named after former Arkansas Blue Cross Blue Shield CEO Robert Shoptaw. 
  7. 43% of adults inadequately insured: Commonwealth Fund

    Forty-three percent of working adults in the U.S. are inadequately insured, according to a Sept. 29 Commonwealth Fund report. 
  8. 7 payer responses to Hurricane Ian

    Health insurers have responded to Hurricane Ian by authorizing prescription refills, waiving prior authorizations, and adding emergency resources and support. 
  9. Centene to pay Massachusetts $14.2M in latest Medicaid overbilling settlement

    Centene will pay $14.2 million to Massachusetts, the latest state the Medicaid managed care organization has paid to settle allegations it overbilled state Medicaid programs for pharmacy services, Kaiser Health News reported Sept. 29. 

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