Dallas-based Baylor Scott & White has named Stephanie Motter as president of its health plan. Ms. Motter previously served as president of Indiana University Health’s Accountable Care Organization. Baylor Scott & White Health Plan serves nearly 500,000 members across employer-sponsored,…
Author: Jakob Emerson
The independent dispute resolution process created under the No Surprises Act has generated at least $5 billion in costs since its launch in 2022, largely due to high dispute volumes and provider wins, according to a study published Aug. 25…
Aetna is rolling out new claims cost control measures under its Claim and Code Review Program, beginning Sept. 1. The new claims editing policy applies to commercial, Medicare and student health members, the company said in June. Aetna may trigger…
Massachusetts has approved $75.6 million in health insurance rebates for more than 350,000 residents and small businesses. The rebates are required under the state’s medical loss ratio law, which mandates that insurers spend at least 88% of premiums on medical…
The Justice Department has expanded its criminal investigation into UnitedHealth Group, examining the company’s pharmacy benefit manager, Optum Rx, and how it compensates its employed physicians, Bloomberg reported Aug. 26. The probe now goes beyond the previously reported potential Medicare…
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Presbyterian Health Plan, the insurance arm of Albuquerque, N.M.-based Presbyterian Healthcare Services, has named Heather Thiltgen as its next president. Ms. Thiltgen previously served as president and CEO of Boston Medical Center’s WellSense Health Plan. She will replace interim president…
As some insurers and health systems pull back on their Medicare Advantage offerings for next year, Intermountain’s Select Health says it is strategically positioning itself for continued, long-term success in the program by focusing on key areas that will drive…
The Colorado House has passed a bill that would look to mitigate the impact of the looming expiration of enhanced ACA premium tax credits at the end of 2025 by providing up to $100 million in state funds to stabilize…
When it comes to managing chronic illness, taking the right medication at the right time can be the difference between stability and a medical crisis. For the more than 70 million Americans enrolled in Medicaid, many of whom live with…
AM Best has downgraded its outlook for the health insurance sector from stable to negative, citing escalating medical costs and increased utilization across government, commercial and ACA plans. The credit rating agency noted higher utilization of specialty drugs, increased physician…