Today's Top 20 Stories
  1. How 5 payers are improving kidney care

    More payers are adding value-based kidney care partnerships and initiatives to address the needs of the nearly 40 million people in the U.S living with kidney disease. 
  2. 41% of small businesses have increased prices due to rising health insurance costs

    Forty-one percent of small business owners said the rising cost of health insurance has caused them to increase prices of goods and services, according to a survey from Small Business for America's Future.  
  3. State Medicaid offices are blocking home patient monitoring. Why?

    Many state Medicaid offices have declined to pay for remote patient monitoring programs despite being touted by successive White House administrations as a way to improve health and reduce unnecessary government spending, Politico reported Oct. 26.  

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  1. How Centene plans to boost its Medicare Advantage star ratings

    With average Medicare Advantage star ratings seeing a decline nationwide, payers like Centene are facing lower revenues in 2024 after missing out on federal bonuses tied to the quality ratings. 
  2. OptumRx denies settlement in Ohio overcharging case

    UnitedHealth Group's OptumRx arm is denying it agreed to pay $15 million to settle overcharging allegations, the Ohio Capital Journal reported Oct. 27. 
  3. Employer-sponsored health premiums are stable, for now: 4 numbers to know

    Average premiums for employer-sponsored health insurance stayed largely stable this year, but that could change soon, according to the annual Employer Health Benefit Survey from Kaiser Family Foundation. 
  4. Meridian of Michigan taps Patricia Graham as CEO

    Meridian of Michigan has named Patricia Graham as CEO. 

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  1. CMS cracks down on Medicare Advantage TV marketing

    CMS is cracking down on deceptive marketing practices and will no longer allow Medicare Advantage or Part D prescription drug plans to advertise on television without agency approval first.
  2. Aspirus Health, Anthem Blue Cross negotiations 'stalled'

    Anthem Blue Cross Blue Shield's contract with Wausau, Wis.-based Aspirus Health is on uncertain terms as the deadline to negotiate a new contract approaches, CBS affiliate WSAW reported Oct. 26.
  3. Centene job creation initiatives canceled by North Carolina officials

    North Carolina officials approved Centene's request to cancel the $450 million in tax incentives the company was set to receive for its Charlotte campus, WSOC reported. 
  4. BCBS Tennessee, CHI Memorial Hospital ink contract

     CHI Memorial Hospital Georgia will be in-network with several Blue Cross Blue Shield Tennessee plans beginning Nov. 1. 

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  1. 'It's like a shakedown': Insurance commissioner addresses U of Mississippi-BCBS impasse

    Mississippi's insurance commissioner said talks between Jackson-based University of Mississippi Medical Center and Blue Cross & Blue Shield of Mississippi are continuing, only without the help of a mediator, ABC affiliate WTOK reported Oct. 26. 
  2. Pennsylvania lawmakers pass prior authorization reform bill

    A Pennsylvania bill aiming to streamline the prior authorization process is headed to the governor's desk after state lawmakers passed the legislation Oct. 26. 
  3. Molina's 61% net income boost in Q3: 5 notes

    Molina Healthcare reported a 61 percent increase in net income in the third quarter of 2022 compared to the same quarter in 2021, according to the company's Oct. 26 earnings report. 
  4. UnitedHealthcare, Apple extend fitness subscription partnership

    UnitedHealthcare will continue to offer free Apple Fitness+ subscriptions to members with employer-funded health plans.
  5. Aetna, Waymark partner on managed care for Virginia Medicaid members

    Aetna Better Health of Virginia and managed care startup Waymark have partnered to provide community-based care services to Medicaid members.
  6. White House touts 2023 ACA marketplace options as 'most competitive in history'

    Ahead of the beginning of open enrollment on the ACA marketplace, the Biden administration is touting 2023 as the most "competitive marketplace in history" for exchange plans. 
  7. Is Colorado's public option working? It depends who you ask

    Colorado Insurance Commissioner Michael Conway says the state's Colorado Option — a state-sponsored plan requiring payers to sell plans at lower prices — was successful. Insurers say it hasn't reduced prices, the Colorado Sun reported Oct. 26. 
  8. CareFirst BCBS, Johns Hopkins ink contract 

    CareFirst BlueCross BlueShield and Johns Hopkins Medicine have signed a multiyear contract following a dispute over reimbursement rates that would have left hundreds of thousands of people out of network.
  9. Humana adding value-based kidney care partnership

    Humana is adding value-based kidney care from in-home provider Monogram Health.

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