Health plans often prioritize managing high-cost areas like pharmacy, behavioral health, and diabetes while overlooking Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). This oversight results in unmanaged costs, leading to care delays, poor member experiences, and missed opportunities for…
The Latest
Ten providers recently posted job listings seeking leaders in payer contracting and relations.
A Texas state judge handed a victory to system-owned health plans that missed out on Texas' Medicaid contract awards, The Dallas Morning News reported Oct. 4.
CMS is proposing new regulations on the ACA marketplace in 2026, which include some aimed at cracking down on fraud.
Centene has completed the sale of Collaborative Health Systems to Astrana Health.
From suing CMS over one phone call to launching its prior authorization gold-card program, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Sept. 11:
The CEO of the nation's largest public health plan plans to keep advocating for Medicaid funding in retirement.
States could better leverage Medicaid managed care organizations to promote maternal health, a report from HHS' Office of Inspector General found.
UnitedHealthcare is expanding its individual and family ACA marketplace plans to four new states and adding 119 new counties in 13 current states for 2025.
Just two Medicare Advantage plans received five-star ratings from the National Committee for Quality Assurance for 2024.