Blue Shield of California and University of California Health hospitals, clinics and physicians across six academic health centers will go out of network on July 10 without a new contract in place. The network split would affect commercial, ACA, Medicare…
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Tupelo, Miss.-based North Mississippi Health Services is out-of-network with UnitedHealthcare Medicare Advantage plans, as of June 1. The split affects UnitedHealthcare MA and dual-eligible special needs plans. North Mississippi Health Services is still in-network with UnitedHealthcare commercial, individual and Medicaid…
Medicare Advantage members are most likely to disenroll from their health plan because of four main reasons: difficulty accessing care, low plan generosity, dissatisfaction with care quality, and the type of plan (HMO vs. PPO), according to a June study…
The Trump administration has boosted payment rates for Medicare Advantage plans, but is also planning what it calls “aggressive” steps to ramp up audits of potential overpayments. Here are seven things to know about the Trump administration’s approach to Medicare…
Enrollment in Blue Cross Blue Shield plans declined slightly between 2022 and 2024, according to a June 10 report by Mark Farrah Associates, a healthcare industry data aggregator. The report examined differences between BCBS and non-BCBS plan growth between 2020…
CVS Health and a former Express Scripts president have reached a settlement with Cigna over allegations that her departure violated a noncompete agreement. Amy Bricker served as president of Express Scripts — Cigna’s pharmacy benefit manager — before resigning in…
Blue Shield of California is partnering with healthcare booking platform Zocdoc to allow members to schedule in-network, in-person and virtual appointments directly on the health plan’s online portal. The partnership is the first time that Zocdoc has worked with a…
AmeriHealth Caritas reported a net loss of $199 million in 2024, the Philadelphia Inquirer reported June 11. AmeriHealth Caritas serves Medicaid enrollees and is jointly owned by Independence Health Group and Blue Cross Blue Shield of Michigan. The company reported…
Groups representing insurers are pushing back on proposed tighter regulations on Medicare Advantage coding. Senate Republicans are considering targeted changes to Medicare Advantage as part of the sweeping “One Big Beautiful Bill.” Lawmakers are considering adding provisions of the No…
Digital tools with a human touch — 4 takeaways on Magellan Health’s partnership with Calm Health
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During a featured session at Becker’s Spring Payer Issues Roundtable in April, leaders from Calm Health and behavioral health provider Magellan Health shared a blueprint for marrying clinical rigor with digital engagement to expand access to behavioral healthcare. Chris Mosunic,…