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Payer Issues

A bad Q1 for Oscar, Bright, Clover | 'Evil empire' nickname for UnitedHealth warranted: Lawsuit | NY creates office to regulate PBMs | Towns with highest insured rates | BCBS names HR chief | 3 top payers for diversity

May 12, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'Evil empire' UnitedHealth schemes to underpay providers, Envision suit alleges Full story 2. BCBS Association names new chief human resources officer Full story 3. Oscar Health, Bright…

Oscar Health to exit 2 states | The healthiest, unhealthiest parts of each state | Former UnitedHealth CEO made $142M in '21 | Cost of treating these diseases grew, fell most | Why HDHPs are rare in Hawaii | Meet Centene's office of the CEO

May 11, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Oscar Health to exit 2 states, releases Q1 earnings Full story 2. Arizona telemedicine owners plead guilty to $64M fraud, kickback scheme Full story 3. Former UnitedHealth CEO…

Hospitals tap insurers for price hikes | 6 payers ranked by Q1 profit | 100 counties with highest uninsured rate | Ark. BCBS names 5 execs | Sentara Health Plan to open care centers | 7 payers entering, exiting markets

May 10, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Arkansas BCBS hires, promotes 5 new execs Full story 2. Clover Health's major growth in Q1: 6 things to know Full story 3. Hospitals tap insurers for…

Cigna's Q1 profit hits $1.2B | Aetna, Anthem execs join Waymark | UnitedHealthcare, WakeMed hit contract snag | What private insurers pay vs. Medicare, by state | Nurses make exit plans after colleague's conviction | US uninsured rate in '21: 9.2%

May 6, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna's $44B revenues in Q1: 7 things to know Full story 2. 9.2% of Americans were uninsured in 2021: 7 things to know Full story 3. WakeMed, UnitedHealthcare…

Centene to sell pharma assets for $2.8B | Cigna launches cancer consult service | 40 medical practices sue UnitedHealth | 4 of the largest health data breaches hit payers | Opinion: Call a surge a surge | 5 payer-provider contract disputes, resolutions

May 5, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Centene to sell Magellan, Pantherx pharmacy businesses for $2.8B Full story 2. Anthem finalizes acquisition of Integra Managed Care Full story 3. The 10 largest data breaches ever…

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Aetna draws surgeons' ire | Prior auth 'gold cards' gain steam | Bright Health Q1 loss swells | $236M Optum, Atrius merger approved | Health plans brace for costly specialty drugs | CVS profit hits $2.3B

May 4, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Bright Health reports major enrollment boost, $180M loss in Q1 Full story 2. 'They're on really thin ice': Why 1 insurer has drawn spine surgeons' ire Full…

UnitedHealthcare limits Aduhelm coverage | 22 hospitals with most ER visits | Payers slam report on MA denials | HHS blocks Ga. plan to bypass ACA | 14 payer exec moves | Seasoned staff join the Big Quit

May 3, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealthcare limits Aduhelm for all health plans: 'unproven and not medically necessary' Full story 2. 22 hospitals with the most ER visits Full story 3. Older, experienced…

19 Tenet hospitals sue Cigna | 8 top payers for diversity | Scrutinize payer mergers, AMA tells feds | 1st human bird flu case found in US | 7 Qs with Priority Health's 1st equity exec | Calif. physician sentenced in $12M Medicare fraud scheme

April 29, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 8 payers named among America's best employers for diversity Full story 2. Black women are leading the charge toward health equity in the payer sphere Full story…

Providence Health Plan seeks 6 C-suite leaders | Molina's Q1 profit up 10% | MA plan prior auth denials concerning: OIG | Former Centene exec joins health tech startup | CMS finalizes ACA plan standardization | Tenet sues OSHA to block inspection

April 28, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. New CMS rule aims to make ACA coverage more accessible, affordable Full story 2. Molina's 10% income boost in Q1: 5 things to know Full story 3. How…

Texas orders payer to stop operations | Highest-paid payer CEOs | Centene updates leadership structure | Humana Q1 profit: $930M | Fauci: US 'out of pandemic phase' | UnitedHealthcare to change radiation prior auths

April 27, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Highest-paid payer CEOs in 2021 Full story 2. Humana's 16% revenue growth in Q1: 7 things to know Full story 3. Texas orders payer to cease all operations Full…

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