Centene is the most likely to overturn a prior authorization denial decision when appealed, while Humana is the least likely, according to a KFF analysis.
Author: Jakob Emerson
The Medicare Advantage business is facing major challenges — government scrutiny is rising, CMS regulations and payments are tightening, the cost of care is rising and negative media coverage abounds.
On average, residents of Mississippi, New Mexico and Florida spend more than 10% of their annual salaries on health insurance premiums for coverage provided by their employer, according to AHIP's 2024 "Coverage at Work" report published in July.
Eight states have at least five million residents that receive health coverage from their employer, according to AHIP's 2024 "Coverage at Work" report published in July.
Blue Cross Blue Shield of Michigan is the most efficient user of technology and most innovative user of artificial intelligence within the BCBS system, according to an Aug. 8 report from Harvard Business Review.
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The nation's largest payers have filed their second-quarter earnings reports, revealing which recorded the largest profits.
The country's largest payers reported year-over-year increases in medical cost ratios, with the exception of Elevance Health, which decreased 0.1%.
In 2024, 32.8 million people are enrolled in Medicare Advantage, or 54% of the eligible Medicare population.
The consumerization of healthcare is accelerating, and the nation's largest health insurer is keeping pace.
Medicaid redeterminations began in April 2023, and all major payers have released their second quarter 2024 earnings, revealing which have recorded the largest enrollment losses in the Medicaid market since redeterminations began.