The federal government has shut down for the first time since 2019 after lawmakers failed to reach a funding deal, with the fate of enhanced ACA subsidies, set to expire at year’s end, hanging in the balance. Premium tax credits…
Author: Jakob Emerson
Elevance Health is deepening its use of artificial intelligence enterprise-wide, focusing on enhancements to its member services, clinical workflows and provider operations as part of long-term efforts to simplify care delivery and reduce costs. Chief Digital Information Officer Ratnakar Lavu…
Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits. The new policy takes effect for dates of service on or…
Optum has named Ben Eklo as its next chief financial officer, effective Nov. 1. Mr. Eklo has been with the company for 18 years, a spokesperson for UnitedHealth Group told Becker’s. He replaces Roger Connor, who was named CFO of…
Molina Healthcare reported a 72% decline in net income for the third quarter and has reduced its adjusted annual earnings guidance for the third time this year to $14 a share as the company faces rising costs in its marketplace…
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Capital District Physicians’ Health Plan has named Barry Thornton II as its next CEO, effective Jan. 1. He succeeds Brian O’Grady, who is retiring after more than a decade at the company. Mr. Thornton currently serves as COO at the…
Johnson City, Tenn.-based Ballad Health is suing UnitedHealth Group for alleged “Medicare Advantage manipulation” that has led to denied care and underpayment for services. The lawsuit was filed Oct. 21 in a Tennessee federal court and claims that UnitedHealth’s actions…
Elevance Health is working to mitigate rising costs in its Medicaid business amid what executives describe as a challenging year ahead. The company reported its third-quarter earnings on Oct. 21, with senior leadership telling investors that escalating Medicaid costs, driven…
Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is laying off 254 employees in a second round of job cuts this year. In March, the company eliminated 110 positions to “reduce administrative costs as medical…
Monongalia County, West Virginia is dropping group coverage from Highmark Blue Cross Blue Shield in favor of Individual Coverage Health Reimbursement Arrangements administered by Take Command, local outlet WAJR reported Oct. 20. Premiums will continue to be almost entirely covered…