Today's Top 20 Stories
  1. UnitedHealth sets quarterly dividend

    UnitedHealth Group's board of directors authorized a $1.88 per-share cash dividend to be paid on Dec. 12. 
  2. Why BCBS Massachusetts is cutting 14K prior authorization requirements

    Blue Cross Blue Shield of Massachusetts' plan to remove 14,000 prior authorization requirements for home care services is a response to the capacity crisis in the state's hospitals, the payer's chief medical officer Sandhya Rao, MD, told NPR affiliate WBUR Nov. 8. 
  3. 13 insurers exiting Medicare Advantage in 2024

    Thirteen insurers are exiting Medicare Advantage markets in 2024, according to an analysis from KFF published Nov. 7. 

The state of AI in healthcare

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  1. Instacart to accept FSA, HSA payments

    Instacart customers will soon be able to directly purchase groceries using their flexible savings- and health savings accounts.
  2. Oscar inks deal with Sanford Health Plan

    Oscar Health reached a new multiyear agreement with Sanford Health Plan to drive member engagement through its +Oscar technology platform. 
  3. States ranked by number of Medicare Advantage plans | 2024

    The average Medicare beneficiary will have 43 Medicare Advantage plans to choose from in 2024, according to an analysis from KFF published Nov. 8. 
  4. Elevance settles noncompete case with former exec who left for Molina

    Indianapolis-based Elevance Health has reached a settlement with a former executive who left the company for a similar role at Long Beach, Calif.-based Molina Healthcare. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Medicare Advantage in the headlines: 10 recent updates

    CMS is proposing a slate of Medicare Advantage policy updates for 2025, and lawmakers are eyeing marketing and networks in the program. 
  2. Humana in the headlines: 9 recent updates

    Humana reported declining income in the face of rising medical costs and is adding new sponsorships. 
  3. Medicare Advantage plans dropping meal benefits, in-home support

    Fewer Medicare Advantage plans will offer nonmedical supplemental benefits like home modifications, adult day health services and therapeutic massage in 2024, according to an analysis from ATI Advisory published Oct. 30. 
  4. States ranked by annual Medicaid managed care spend

    New York spends the most on its Medicaid managed care program every year, according to data published by KFF in November. The U.S. total is more than $441 billion.

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. 'Flagrant disregard of the law': Nebraska revokes Bright Health's insurance license

    Nebraska has fined Bright Health $1 million and revoked its insurance license with the state following a market conduct examination that found the company violated state law more than 21,000 times over a period of two years.
  2. 7 prior authorization updates

    From UnitedHealthcare starting its second wave of cuts to lawmakers urging CMS to increase its oversight of artificial intelligence used in Medicare Advantage prior authorizations, here are seven updates on prior authorization Becker's has reported since Sept. 18. 
  3. CMS proposes new Medicare Advantage audit appeals process

    CMS is proposing a standard appeals process for risk adjustment data validation audits in Medicare Advantage. 
  4. Why Humana is sponsoring 4 pickleball organizations

    Humana announced it is sponsoring four pickleball organizations in response to the increasingly popular sport's "life-changing benefits both on and off the courts," according to a Nov. 6 news release. 
  5. CMS proposes more crackdowns on Medicare Advantage marketing, broker payments

    CMS is proposing a set of new Medicare Advantage rules, including new standards that would impose more limits on plans' payments to brokers and limit the role of third-party marketers. 
  6. CMS proposes health equity mandates for Medicare Advantage prior authorizations

    CMS is proposing new health equity changes for prior authorization policies and procedures at Medicare Advantage organizations to better determine any disproportionate impact on underserved populations that may delay or deny access to services. 
  7. Lawmakers probe Medicare Advantage plans' use of AI

    A group of federal lawmakers is asking CMS to increase its oversight of artificial intelligence and algorithms used in Medicare Advantage prior authorization decisions. 
  8. BCBS Illinois fined a third time for network adequacy law violations

    The Illinois Department of Insurance has fined Health Care Service Corp., the parent company of Blue Cross Blue Shield of Illinois, nearly $1.2 million in less than two years for violating the state's Network Adequacy and Transparency Act, which requires payers to publish complete and accurate provider directory information. 
  9. Medicare Advantage doesn't hurt rural hospitals: Study

    Increasing Medicare Advantage enrollment in rural areas did not increase rural hospitals' financial distress or risk of closing, a study published Nov. 3 in the American Journal of Managed Care found. 

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