Today's Top 20 Stories
  1. Medicare Advantage premiums, benefits stable for '25, CMS says: 10 notes

    Average Medicare Advantage premiums and Medicare Part D premiums will decrease in 2024, CMS said Sept. 27. 
  2. 4 Medicare Advantage plans audited for overpayments

    HHS' Office of Inspector General has published audits of four Medicare Advantage plans in the past two months. 
  3. Payers with the best telehealth services in 2024: J.D. Power

    Among major payers, customers are most satisfied with the telehealth offerings from Humana and Florida Blue, according to the "J.D. Power 2024 U.S. Telehealth Satisfaction Study."

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  1. Another health system scales back its Medicare Advantage plan

    University of Vermont Health Network and MVP Health Care will no longer offer their joint Medicare Advantage plan in Vermont in 2025. 
  2. How BCBS Massachusetts built one of the nation's best health plans

    Blue Cross Blue Shield of Massachusetts boasts one of the highest-quality health plans in the nation, beating out more than 1,000 other products across every insurance market.
  3. CMS publishes new guidance on Medicaid, CHIP coverage: 7 things to know

    CMS is providing states new guidance to ensure states comply with required Medicaid services for children. 
  4. OIG audits Humana, Aetna for Medicare Advantage overpayments: 10 things to know

    Subsidiaries of Aetna and Humana received millions in Medicare Advantage overpayments in 2017 and 2018, the HHS Office of Inspector General alleged in audits published Sept. 25. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. 16 payer headwinds to know 

    Payer executives are keeping a close eye on a shifting regulatory environment and ongoing provider shortages. 
  2. Startup Medicare Advantage plan gets $140M

    Startup Medicare Advantage plan Zing Health has raised $140 million in funding. 
  3. Health systems back Centivo in $75M financing round

    Centivo, a Buffalo, N.Y.-based health plan administrator for self-insured employers, has secured $75 million in equity and debt financing.
  4. 10 providers seeking payer contracting talent

    Ten providers recently posted job listings seeking leaders in payer contracting and relations.

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. The biggest barrier to value-based success, per 1 exec

    Resistance to change is the biggest barrier to value-based care, Monica Engel, senior vice president of Government Markets at Blue Cross Blue Shield of Minnesota, told Becker's. 
  2. The lowest-rated health plans of 2024: NCQA

    Of the 1,019 health plans rated by the NCQA in 2024, 13 received a rating of 2 stars or lower. 
  3. How a 5-star Medicare Advantage plan approaches growth

    Medicare Advantage plans "lacking substance" will not stand the test of time, Jordan Reigel, president of Essence Healthcare, told Becker's. 
  4. CMS: States have 2 years to fix Medicaid renewal problems

    States must be in full compliance with all of CMS' Medicaid renewal requirements by the end of 2026.  
  5. UnitedHealthcare to add school-based mental health support in 14 states

    UnitedHealthcare will provide mental healthcare to 1 million children in schools through a partnership with Hazel Health. 
  6. The top GLP-1 challenge facing UPMC's health plan

    Insurers, health systems, state health plans and self-funded employers are all grappling with how to cover the high cost of GLP-1 medications, with some large organizations limiting coverage or dropping benefits entirely in 2024.
  7. States with largest Medicaid enrollment declines

    With Medicaid redeterminations complete in most states, Medicaid enrollment has decreased by 14.3% from March 2023, according to KFF. 
  8. CVS Health sets quarterly dividend

    CVS Health's board of directors approved a $0.665 per-share dividend to be paid Nov. 1. 
  9. The best-rated commercial health plans in each state: NCQA

    Three commercial plans received five-star ratings from the National Committee for Quality Assurance. 

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