Today's Top 20 Stories
  1. Meet CVS Health's leadership team

    CVS Health recently expanded the roles of three of its C-suite executives and welcomed a new president of Aetna. Here is more information about executives that make up CVS Health's leadership team, according to the company's website:  
  2. Medicaid coverage helped lower uninsured population in 2022 as poverty level soared

    Additional Medicaid coverage enacted during the COVID-19 pandemic helped keep the number of uninsured people down at record lows in 2022 even as poverty levels soared, according to a Sept. 12 New York Times report.
  3. 5 prior authorization updates

    From payers announcing cuts, to a lawmaker investigation denials, here are five updates about prior authorizations Becker's reported since Aug. 17: 

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  1. Texas awards 7 payers new contracts to manage Medicaid long-term services

    Seven payers, including UnitedHealthcare, Molina Healthcare and Centene subsidiary SuperiorHealth Plan, were awarded contracts to manage Texas' STAR +PLUS program, which provides Medicaid to adults with disabilities or are 65 years of age and older. 
  2. Will Mississippi move on Medicaid expansion in 2024?

    Mississippi could consider Medicaid expansion next year, Mississippi Rep. Jason White told Mississippi Today. 
  3. Many older adults overwhelmed by too many Medicare options: Survey

    The majority of older adults say they would stick with their current Medicare plan rather than switch to a different plan when they feel they have too many options, a survey from the Commonwealth Fund found. 
  4. Top Medicare supplement plans of 2023, per Forbes 

    Humana offers the best Medicare supplement plan in 2023, according to a ranking published Sept. 7 by Forbes Health.

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. Major payers drop senior companionship company following patient abuse allegations 

    Humana, Aetna and Molina are not renewing their contracts with senior companionship company Papa following allegations of abuse against patients or company employees, Bloomberg reported Sept. 11.
  2. Empire BCBS, Catholic Health ink value-based contract 

    Empire BlueCross BlueShield and Rockville Centre, N.Y.-based Catholic Health have partnered on a multi-year value-based payment and care delivery model.
  3. Elevance Health sues to block former Medicare executive from joining Molina

    Elevance Health is seeking to block a former regional Medicare president from taking a similar role at Molina Healthcare, alleging the former executive is in possession of trade secrets that would inevitably be disclosed to Molina. 
  4. Hawaii pausing Medicaid terminations in wake of wildfires

    Hawaii is pausing Medicaid disenrollments for all Hawaii residents for the remainder of 2023 in the wake of the Maui wildfires. 

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. Medicaid spending on Ozempic, other GLP-1 drugs, topped $1B in 2022

    Medicaid spent $1.1 billion on Ozempic and other GLP-1 drugs that can be used for weight loss in 2022, a KFF analysis published Sept. 8 found. 
  2. What 8 recent studies found about Medicare Advantage

    Much of Medicare Advantage growth is driven by people switching to the program from traditional Medicare, and this growth is picking up speed in rural areas. 
  3. 26 payer executives' advice for future industry leaders

    Future leaders in the health insurance industry should stay curious, keep an eye toward the future and put members first, executives say. 
  4. Optum-Amedisys deal receives shareholder approval

    In an overwhelming majority, Amedisys shareholders approved a $3.3 billion acquisition by UnitedHealth Group's Optum on Sept. 8.
  5. Medicaid disenrollment rates by state

    The Medicaid disenrollment rate for reporting states as of Sept. 8 ranges from 72 percent in Texas to 9 percent in Michigan, according to KFF. 
  6. L.A. Care Health Plan to pay $1.3M to settle alleged HIPAA violations

    L.A. Care Health Plan has agreed to pay a $1.3 million settlement and to implement a corrective action plan to resolve allegations that it violated HIPAA regulations.
  7. Medicare Advantage in the headlines: 9 recent updates

    Humana is challenging a rule from CMS that could leave insurers on the hook for billions in repayments, and new HHS research reveals most growth in the program is fueled by people switching from traditional Medicare. 
  8. Throw out the fax machine: Blue Shield of California's CEO on conquering healthcare's inertia

    Paul Markovich has spent more than two decades at Blue Shield of California, the past 10 as its president and CEO. 
  9. Top Medicare Part D plans of 2023, per Forbes 

    UnitedHealthcare offers the best Medicare Part D prescription drug plan in 2023, according to a ranking published Sept. 8 by Forbes Health.

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