UnitedHealthcare has named Toyosi Okurounmu, MD, as national chief medical officer and vice president of medical leadership and clinical performance for its community and state division, which provides managed Medicaid services across 30 states.
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Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans.
UnitedHealthcare says it did not breach its contract with Greenville, S.C.-based Prisma Health, and said the health system "coordinated a media effort to put pressure" on the insurance giant.
The first wave of UnitedHealthcare's prior authorization cuts began Sept. 1.
Blue Shield of California CEO Paul Markovich won't be surprised if other payers ditch traditional pharmacy benefit managers for a new model.
Centene has moved to divest its overseas businesses and lost out on contract decisions in recent weeks.
GoodRx has launched a new feature that allows providers to check a patient's insurance benefits when prescribing medications to better understand the final cost.
Centene is planning to sell its Operose clinics in the U.K., its last remaining business in the country, the Financial Times reported Aug. 30.
Wegovy, Novo Nordisk's expensive weight loss drug, could reduce the risk of cardiovascular events — but at a steep cost to insurers, Bloomberg reported Aug. 31.
Health plans have historically struggled to deliver personalization that increases member engagement, improves care coordination, drives better outcomes and reduces costs. That’s despite spending 10% or more of their administrative budget on care management, according to McKinsey & Company, which…