Today's Top 20 Stories
  1. 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. 
  2. 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.
  3. 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.

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  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. 

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  1. 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. 
  2. 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.
  3. UnitedHealth sets quarterly dividend

    UnitedHealth Group's board of directors authorized a $1.88 per-share cash dividend to be paid on Dec. 12. 
  4. 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. 

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. 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. 
  2. Instacart to accept FSA, HSA payments

    Instacart customers will soon be able to directly purchase groceries using their flexible savings- and health savings accounts.
  3. 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. 
  4. 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. 
  5. 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. 
  6. 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. 
  7. Humana in the headlines: 9 recent updates

    Humana reported declining income in the face of rising medical costs and is adding new sponsorships. 
  8. 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. 
  9. 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.

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