Today's Top 20 Stories

  1. Cigna reportedly considering selling Medicare Advantage business

    Rylee Wilson -
    The Cigna Group is exploring a potential sale of its Medicare Advantage business, Reuters exclusively reported Nov. 6. 

  2. BCBS Massachusetts to cut 14,000 prior authorization requirements

    Jakob Emerson -
    Blue Cross Blue Shield of Massachusetts is removing 14,000 prior authorization requirements for home care services for its 2.6 million commercial members beginning Jan. 1. 

  3. Providence Health Plan taps 3 new finance execs

    Jakob Emerson -
    Providence Health Plan has added three new executives to its finance team, according to a Nov. 1 news release.

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  1. 23 payer executives' top priorities for 2024

    Rylee Wilson -
    Payer leaders are turning their attention to health equity, prior authorization, AI and more as 2024 approaches. 

  2. Allstate looking to sell health benefits division

    Jakob Emerson -
    Allstate is looking to sell its health benefits division in 2024, CEO Tom Wilson told investors on a Nov. 2 quarterly earnings call.

  3. NCAA president, former Massachusetts governor joins UnitedHealth Group board

    Rylee Wilson -
    UnitedHealth Group has named Charlie Baker to its board of directors. 

  4. New York payer laying off 68 employees

    Jakob Emerson -
    AgeWell, a specialty managed care insurer, is laying off 68 employees at its headquarters in Lake Success, N.Y., according to regulatory documents published by the state Oct. 31.

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  1. Payers ranked by total enrollment in Q3

    Jakob Emerson -
    The nation's largest payers have filed their third-quarter earnings reports, revealing which grew total member enrollment and business lines the most year over year.

  2. Payers ranked by medical loss ratios in Q3

    Jakob Emerson -
    The nation's largest payers have filed their third-quarter earnings reports, revealing how medical loss ratios changed year over year. Individual BCBS company MLRs for the first half of 2023 are here.

  3. Prisma Health still wants a restraining order against UnitedHealthcare

    Rylee Wilson -
    Greenville, S.C.-based Prisma Health is asking a judge to reconsider its request for a restraining order against UnitedHealthcare over allegations the insurer breached its confidentiality agreement with Prisma, as the two sides approach a Jan. 1 deadline to reach a new network agreement. 

  4. Where Cigna sees opportunity in weight loss drugs

    Rylee Wilson -
    The Cigna Group is expecting a program that offers employers ways to manage the high cost of new weight loss drugs to grow. 

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. Humana, Memorial Hermann at impasse as deadline nears

    Andrew Cass -
    Houston-based Memorial Hermann issued termination notices for Humana's Medicare Advantage HMO and PPO networks and could go out of network if a new deal is not reached by Jan. 1, Houston Public Media reported Jan. 1. 

  2. Payers ranked by Q3 revenue, profit

    Jakob Emerson -
    The nation's largest payers have filed their third-quarter earnings reports, revealing which grew their revenues and net incomes the most year over year. Individual BCBS company revenues and profits in the first half of 2023 are also available.

  3. Medicare Advantage members have fewer hospital readmissions than traditional Medicare: Report

    Rylee Wilson -
    Medicare Advantage enrollees have 70% lower hospital readmission rates than their counterparts in fee-for-service Medicare, a white paper from researchers at Boston-based Harvard Medical School and software firm Inovalon found. 

  4. Why SCAN Group is betting on population-specific Medicare Advantage plans

    Jakob Emerson -
    There are nearly 4,000 Medicare Advantage plans for older adults to choose from nationwide for 2024, and payers are launching unique benefits aimed at serving specific and segmented populations.

  5. Most insured patients on Wegovy pay less than $25 per month: Novo Nordisk

    Erica Carbajal -
    Eighty percent of patients in the U.S. with insurance coverage who are taking Novo Nordisk's weight loss drug Wegovy pay less than $25 a month for the drug, CNBC reported Nov. 2. 

  6. CVS names Aetna Medicaid president

    Jakob Emerson -
    CVS Health has named Mark Santos as president of Aetna Medicaid. 

  7. Humana payment rates for diabetes with complications

    Andrew Cass -
    Humana PPO payment rates for diabetes with complications ranged from $31,998 for Houston-based Memorial Hermann to $6,376 for Johnson City, Tenn.-based Ballad Health, according to data compiled by Hospital Pricing Specialists.

  8. Optum to move out of 54-acre Minnesota campus by year's end

    Rylee Wilson -
    Optum will move out of an Eden Prairie, Minn.-based campus with 473,000 square feet of office space by the end of 2023, the Minneapolis/St. Paul Business Journal reported Nov. 2. 

  9. Medicaid disenrollments top 10 million

    Rylee Wilson -
    More than 10 million people have been disenrolled from Medicaid since continuous coverage requirements ended in April, according to KFF. 

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