Kaiser Permanente has been named the top health insurance company in the U.S. for a sixth consecutive year, according to Insure.com’s annual ranking. In the final 1 through 5 score, 60% came from a customer survey, 25% from NCQA health…
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Today’s Medicare Advantage payers are navigating rising enrollment, changing HCC models and heightened audit scrutiny from CMS. At the same time, quality standards continue to tighten, putting Star Ratings and revenue at risk when documentation and coding fall short. This…
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Ten states have still not expanded Medicaid under the ACA. If those states were to move toward expansion, 2.3 million people would secure health insurance coverage. While Medicaid expansion has long been a possibility, there is still some room for…
In a Feb. 9 exchange with The Topeka Capital-Journal, Democratic Gov. Laura Kelly of Kansas appeared to acknowledge her lame-duck status regarding her attempts to achieve Medicaid expansion for the state, a longtime key item of her administration’s platform. “There’s…
The Washington State Court of Appeals ruled that Zion HealthShare, a medical cost-sharing nonprofit, is operating as an insurer, according to a Feb. 5 filing. Zion HealthShare calls itself “an affordable, community-driven alternative to traditional health insurance.” Because Zion was…
A University of Minnesota Medical School course formed in partnership with UnitedHealth Group will undergo revisions, the Minneapolis-based school confirmed to Becker’s Feb. 11. First taught in 2024, “Leadership and Value: A UnitedHealth Group-UMN Collaboration” is a fourth-year elective that…
Dallas-based Tenet Healthcare expects a 20% reduction in ACA exchange enrollment this year with the expiration of enhanced premium tax credits set to pressure hospital earnings and payer mix. The company is projecting adjusted EBITDA of up to $4.8 billion…
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Baylor Scott & White Health, based in Dallas, seeks a director of payer…
Honolulu-based Hawaii Pacific Health, which is seeking to affiliate with Blue Cross Blue Shield licensee Hawaii Medical Service Association under a new nonprofit parent organization, reported an operating loss of $13.6 million (-1.3% operating margin), through the second quarter of…
Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., have introduced legislation that would prohibit companies from simultaneously owning a health insurer or pharmacy benefit manager and a medical provider or management services organization, and would require companies in violation to…