Major payers reported mixed third-quarter results amid rising medical costs and operational headwinds, a stark contrast to the more robust performance seen by some of the largest for-profit health systems. Becker’s compared Q3 performance across six major payers — UnitedHealth…
Author: Alan Condon
CMS is set to launch a pricing model in January that could reshape Medicaid drug costs by aligning them with rates seen in other high-income countries. Eight things to know: 1. The program allows participating drug manufacturers to offer Medicaid…
Highmark Health Plan has appointed Kate Musler CFO. Four things to know: 1. Ms. Musler previously served as senior vice president of risk management and provider networks for Highmark Health Plan, where she was responsible for actuarial, underwriting and provider…
Texas Attorney General Ken Paxton's Healthcare Program Enforcement Division has secured a $40 million settlement from Molina Healthcare under the Texas Health Care Program Fraud Prevention Act.
Donald Trump's second term as president likely will have significant implications for healthcare, including the Medicare Advantage program, which provides health coverage to more than half of the nation's older adults.
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Elevance Health sold Miami-based Pasteur Medical Centers and Wellmax Medical Centers to Las Mercedes Medical Centers, which is also headquartered in Miami.
St. Louis-based Mercy has notified Anthem Blue Cross Blue Shield that it will go out-of-network with the insurer in Missouri if a new agreement is not reached by Jan. 1, 2025.
The Massachusetts Department of Public Health has launched an initiative that redirects patients not needing emergency-level care to urgent care providers to address "severe capacity challenges" at hospital emergency departments in the eastern part of the state.
Hundreds of people, including physicians, patients and Oregon Senate Majority Whip Sara Gelser Blouin, have urged the state department of health to block Optum's proposed acquisition of Corvallis (Ore.) Clinic, the Corvallis Gazette-Times reported Feb. 8.
UCHealth Plan Administrators is joining Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health that serves more than 1 million members across Utah, Idaho and Nevada.