May is Women’s Health Month, a time dedicated to raising awareness about the unique health challenges faced by women. As we end the month, this is a good time to look at the accumulating evidence that shows significant disparities in…
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The clinical data goldmine: How HIEs are poised to transform payer efficiency & patient outcomes
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As healthcare becomes increasingly data-driven, payers are turning to clinical health record data to strengthen claims processing, care coordination and risk management. This shift reflects a broader industry trend toward more integrated, real-time data use across the care continuum. With…
Elevance Health’s Carelon is ceasing operations in Ireland and will lay off 300 employees in Limerick, the Irish Times reported May 28. “After carefully considering alternatives and conducting a consultation process with employee representatives, we have made the difficult decision…
Blue Cross Blue Shield of Minnesota and Blue Cross Blue Shield of North Dakota are the first two insurers to earn URAC’s Mental Health/Substance Use Disorder Parity Accreditation. The certification is the only program of its kind in the U.S.,…
Priority Health is partnering with Virta Health on three new solutions aimed at addressing demand for weight management options and diabetes support among employers and employees. The solutions include nutrition programs and multi-specialty clinical support to help members lose weight…
Walmart is launching new digital offerings that will integrate with Medicare Advantage supplement plans. Members will be able to choose from plan-specific, benefits-eligible products while shopping online for same-day pickup or delivery in as soon as an hour, according to…
UnitedHealthcare Community & State CEO, Krista Nelson, has been named COO at Optum Health. Ms. Nelson served as CEO of the company’s Medicaid division beginning in 2024, and she has been with the company since 2009. “It has been an…
The gaps between the highest and lowest rated commercial health plans for customer satisfaction are growing, according to J.D. Power’s U.S. Commercial Member Health Plan Study. J.D. Power published its annual ranking of the top commercial health plan in each…
An investor-led lawsuit has been dropped against UnitedHealth Group, its former CEO Andrew Witty, and CFO John Rex, which alleged the company misled investors about its corporate strategy in the aftermath of the December killing of UnitedHealthcare CEO Brian Thompson. …
States that extend Medicaid coverage to individuals without legal status will receive fewer federal Medicaid dollars if budget legislation passed by the House of Representatives is finalized, according to KFF. The legislation would reduce federal Medicaid funding matches to 80%…