Today's Top 20 Stories
  1. UnitedHealth provides humanitarian aid to Israel, Gaza

    The United Health Foundation is donating $1 million toward humanitarian aid for civilians affected by the ongoing Israel-Hamas war. 
  2. How Allina Health | Aetna avoids negotiation 'quibbles'

    As a provider-integrated plan, Allina Health | Aetna can focus on quality rather than network negotiations, Chief Medicare Officer Britta Orr says. 
  3. Intermountain's health plan aims to end PBM 'games' through Cuban partnership

    Intermountain Health's insurance arm, Select Health, has rolled out a new partnership with Mark Cuban's Cost Plus Drug Co. to its more than 1 million members — a move its chief pharmacy benefits officer said is aimed at eliminating "all the games" in the PBM marketplace.

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  1. Health Care Service Corp. rebrands Trustmark Health Benefits 

    Health Care Service Corp. has rebranded Trustmark Health Benefits to Luminare Health.
  2. What 4 recent studies found about Medicare Advantage

    Medicare Advantage enrollees tend to have lower hospital readmissions rates and expenses than their counterparts in fee-for-service, studies have uncovered. 
  3. Medicaid in the headlines: 7 recent updates

    More than 10 million people have been disenrolled from Medicaid through the redeterminations process, and plans are facing fines for violating mental health parity laws. 
  4. BCBS Association: ACA risk adjustment is working

    ACA marketplace risk adjustment payments are working as intended, an analysis from Oliver Wyman, commissioned by the Blue Cross Blue Shield Association, found. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. BCBS Association sued over alleged disclosure of federal employee data to TikTok 

    The Blue Cross Blue Shield Association allowed federal employees' sensitive medical information to be obtained by third-party technology companies, including TikTok, according to a lawsuit filed Nov. 7 in a federal court in Chicago.
  2. Independence Blue Cross names VP of Medicare sales and marketing

    Independence Blue Cross has named Theresa Lauer as vice president of sales and marketing — Medicare. 
  3. Biden expands VA eligibility

    Starting this month, all living World War II veterans will be eligible to access healthcare services at no cost through the Department of Veterans Affairs, the White House said Nov. 10.
  4. UnitedHealthcare's provider network size by state

    UnitedHealthcare has the most in-network physicians and healthcare professionals in California, according to the company's website.

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. Feds ramp up Medicare Advantage scrutiny

    The federal government is ramping up scrutiny of Medicare Advantage plans. 
  2. 'Worse than people can imagine': 5 Medicaid redeterminations updates

    It's been more than seven months since the first states began the process of unwinding the continuous Medicaid enrollment period in place for three years during the pandemic, resulting in state agencies and beneficiaries reporting major operational challenges and exacerbated care access issues.
  3. New York fines 5 Medicaid MCOs $2.6M over behavioral claims denials

    New York has fined five Medicaid managed care plans a total of $2.6 million following an examination of their reimbursement of behavioral health claims that found "repeatedly and inappropriately denied claims" or failure to pay for services at rates required by law.
  4. Aetna, OHSU reach new deal

    Portland-based Oregon Health & Science University and Aetna have averted a looming contract split. 
  5. 4 payers entering Medicare Advantage in 2024

    Four new insurers will enter the Medicare Advantage market in 2024, according to an analysis from KFF published Nov. 8. 
  6. Major payers to offer Medicare Advantage plans in more counties in 2024

    Major health insurers are offering Medicare Advantage plans in more counties in 2024 than they did in 2023, according to a Nov. 8 report from KFF.
  7. UnitedHealth sets quarterly dividend

    UnitedHealth Group's board of directors authorized a $1.88 per-share cash dividend to be paid on Dec. 12. 
  8. 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. 
  9. 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. 

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