Author: Rylee Wilson

Provider groups are joining in payers' concerns about CMS' proposed changes to Medicare Advantage risk adjustments and diagnosis coding. 

Humana CEO Bruce Broussard says proposed Medicare Advantage payment rate changes from CMS will not affect the company's 2024 outlook, Bloomberg reported March 7. 

Fresno, Calif.-based Community Health System is back in network with Anthem Blue Cross after a split lasting six months. 

Blue Cross and Blue Shield of North Carolina reported a net income of $36 million in 2022, for a thin net operating margin of .33 percent. 

Insurers are urging CMS not to implement proposed risk adjustment changes in Medicare Advantage, but some nonprofit payers say the changes could create a more level playing field for community plans. 

Humana is set to exit the commerical group medical insurance business, phasing out its employer group commercial medical products over the next 18 to 24 months. The exit leaves just under 1 million members who will need to shift to other…

Oscar Health will keep CVS Caremark as its pharmaceutical benefit manager through 2026.

Blue Cross Blue Shield of Michigan is relocating the headquarters of subsidiary Blue Care Network, moving 500 employees from its Southfield, Mich., campus to Detroit, the Detroit Free-Press reported March 3.

People with long COVID-19 are at higher-risk for a number of adverse cardiovascular and pulmonary events, a study from Elevance Health found. 

Insurers are ramping up campaigns and adding staff to let Medicaid members know about redeterminations.