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Payer Issues

Aetna deems Aduhelm medically necessary | Uninsured, publicly insured more likely to report negative care experience | BCBS Texas, Amarillo health system to cut ties | McKinsey: MA star ratings to decline in 2023 | Where Medicaid acceptance is greatest

September 22, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Aetna: Aduhelm is medically necessary  Full story 2. Uninsured, publicly insured more likely to report negative care experiences Full story 3. A timeline of UnitedHealth Group's acquisition of Change Healthcare Full…

'Already a 3-headed dragon': Medical groups on UnitedHealth-Change | Optum names chief digital officer | AMA, AHA dropping No Surprises Act suit | BCBS, Texas Health Resources contract to end | Google adds Medicaid search filters

September 21, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'Already a three-headed dragon': Medical groups rebuke judge's approval of UnitedHealth, Change merger Full story 2. AMA, AHA move to dismiss No Surprise Act lawsuit, but concerned about…

Judge clears UnitedHealth-Change deal | Best commercial plans in each state | Centene to pay $166M in Texas Medicaid settlement | Humana looks to recover MA growth | Former UnitedHealthcare CEO heads to JenCare | 8 payers entering markets

September 20, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Judge signs off on UnitedHealth-Change deal, rejects DOJ challenge Full story 2. Centene to pay Texas $166M to settle Medicaid fraud allegations Full story 3. The top-rated commercial health plans in…

UnitedHealth beats facility fee lawsuit | DOJ charges 9 for prostitution billed to health plan | Hospitals' most financially difficult year | Best health plans of 2022, per NCQA | States ranked by uninsured residents | 10 exec moves

September 16, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Judge rules in favor of UnitedHealth in facility fees class-action Full story 2. 2022 the most financially difficult year for hospitals, health systems since start of pandemic Full story 3. DOJ…

HHS set for 11th renewal of COVID PHE | House passes MA prior auth. reform | Q&A: UCare CEO | BCBS NC's value-based programs have saved $500M | Record uninsured rate to fall further | States ranked by Medicare telehealth use | 10 virtual care moves

September 15, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. HHS expected to renew COVID-19 PHE for 11th time Full story 2. House passes Medicare Advantage prior authorization reform bill: 4 things to know Full story 3. Q&A with UCare's CEO…

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No Surprises Act may surge ER visits | Oregon weighs single-payer | Optum's Minn. campus up for grabs | Where Medicare acceptance is greatest | HCSC expands virtual care to Ill., Texas | People in cities use telehealth most, OIG finds

September 14, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Oregon legislature to decide on single-payer system Full story  2. Study: No Surprises Act could result in millions more emergency department visits Full story 3. Cities with the highest Medicare acceptance…

UnitedHealthcare, Envision feud over payments in court | CarePoint accuses competitors of trying to 'destroy' hospitals | Noncitizens can use Medicaid, CHIP: DHS | AMA joins class action against Cigna | BCBS Tenn. goes permanently remote

September 13, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'Cold, callous and inhumane': UnitedHealthcare, Envision battle in federal court Full story 2. CarePoint accuses RWJBarnabas Health, Horizon BCBS of aiming to 'destroy' 3 hospitals in lawsuit Full story 3. DHS:…

Amazon wants payer talent | Judge questions DOJ in UnitedHealth, Change challenge | What Aetna gains from Signify | CareFirst, Johns Hopkins near breakup | Highmark's VBC programs are saving billions | 4 terminated payer contracts

September 9, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Judge casts doubt over Justice Department's challenge of UnitedHealth's Change acquisition Full story 2. CareFirst BCBS, Johns Hopkins terminate contract Full story 3. What $8B buys Aetna with Signify Full story…

Judge gives partial win to ACA opponents | Long COVID is a major employer healthcare cost | Health systems' digital investment picks | Payers are ditching offices nationwide | Aetna expands ACA plans in 10 states | 13 payers entering, exiting markets

September 8, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Federal judge awards partial victory to ACA opponents, rules against HIV drug coverage Full story 2. Where health systems are investing digital health dollars Full story 3. Long COVID outpacing diabetes…

Payers ranked by CEO-to-worker pay ratio | UnitedHealth, Walmart partner on MA | Where every insurance premium dollar goes | Mark Cuban's Cost Plus nears 1M customers | UnitedHealthcare launches ACA plans in 4 states | WellCare Ky. names 2 execs

September 7, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth, Walmart partner on value-based senior care, will launch co-branded health plan Full story 2. Mark Cuban's pharmacy nears 1M customers Full story 3. Where every insurance premium dollar goes Full story…

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