Payer Issues Archives - Page 28 of 177 - Becker's Payer Issues

Centene pulls earnings outlook | Senate passes GOP budget bill, payers urge House reversal | Hospital CEOs side-eye prior auth promises | The best, worst states for healthcare | 5 GLP-1 updates

July 2, 2025 1. Centene withdraws 2025 earnings guidance: 5 things to know Full story 2. Senate passes GOP budget bill, heads to House: 9 things to know Full story 3. What's next for value-based care? Aetna, Emblem & BCBS…

Feds charge 324 in $14.6B healthcare fraud bust | Memorial Sloan Kettering, UnitedHealthcare reach deal | Top insurers for customer experience | 5 MA bills in Congress | Mark Cuban: Another way to lower Medicaid spending

July 1, 2025 1. Feds unveil largest healthcare fraud takedown: $14.6B in alleged schemes, 324 charged Full story 2. Prior authorization in 2025: What to know Full story 3. Still using legacy systems? Learn what it's costing your data strategy…

Medicare explores prior auth | SCOTUS upholds ACA preventive care mandate | Wis. payer to cut jobs | Blue Shield Calif. cuts MA broker payments | Humana strikes another GLP-1 partnership

June 30, 2025 1. CMS to add prior authorization for traditional Medicare services Full story 2. Supreme Court upholds ACA preventive coverage mandate Full story 3. BCBS, Cigna & Humana are rethinking cost, access and experience. Their game plan —…

Optum Health CEO exits role | GOP Medicaid plan hits a snag | Ohio pauses insurer's operations | What 8 studies found about MA | How a nonprofit payer made the Fortune 500

June 27, 2025 1. Optum Health CEO exits role Full story 2. Ohio seeks to ban Texas insurer from operating in the state Full story 3. Close care gaps faster with EHR-integrated alerts. Get next steps: here. 4. Medicaid changes don't meet…

How a Texas payer cut prior auth denials to 7% | CVS fined $95M for inflating Medicare drug prices | Insurers lag on customer experience | Optum launches AI marketplace | 10 recent billing fraud cases

June 26, 2025 1. How a Texas payer cut prior auth denials to 7% ahead of industry reform pledge Full story 2. CVS Caremark ordered to pay $95M for inflating Medicare drug prices Full story 3. CMS is cracking down…

MA tied to longer hospitalizations, lower costs | Some UnitedHealth workers return to office | Humana affected by Novo Nordisk, Hims & Hers split | ACA enrollment could shrink by 50% | RFK Jr. leans into wearables

June 25, 2025 1. Medicare Advantage members have longer hospital stays than those with traditional Medicare: NORC study Full story 2. Medicare Advantage, traditional Medicare cost gap widening: Better Medicare Alliance Full story 3. What's really shaping payer strategy in…

Ga. health system bets on new insurance model | Optum subsidiary reports data breach | Medicare faces 2033 cliff | Lawmakers target MA, VA loophole | 20 payers cutting jobs

June 24, 2025 1. Why a Georgia health system is investing in a new insurance model Full story 2. Optum subsidiary reports February data breach Full story 3. Care navigation doesn't have to be chaos. See how payers are leveling…

Payers to ease prior auths | NYC reverses course on Aetna MA plan | CMS finalizes ACA integrity rule, raises MA commission caps | Trump’s approach to PBMs | 12 drugs in shortage

June 23, 2025 1. Payers to reduce prior authorizations Full story 2. CMS finalizes rule to improve ACA marketplace integrity, lower premiums Full story 3. What's next for value-based care? Aetna, Emblem & BCBS are scaling smarter models — learn…

Medicaid top of mind for payer execs | Court greenlights NYC's Aetna MA plan | Optum West CEO departs | MA enrollees see fewer home health visits: MedPAC | 4 GLP-1 updates

June 20, 2025 1. Medicaid top of mind for payer execs: 15 leaders' biggest priorities Full story 2. State high court greenlights New York City's $15B Aetna Medicare Advantage plan Full story 3. The AI agent advantage is real — and…

Tariffs threaten to raise premiums | Judge OKs class-action against BCBS Mont. | MA architect: The system is being abused | More payers seek higher ACA rates | Walmart launches MA, Medicaid wellness program

June 19, 2025 1. Tariff threats contribute to rising premiums: 3 things to know Full story 2. Why an architect of Medicare Advantage says the 'system is being abused' Full story 3. $57.7B lost to avoidable readmits. How LTACHs are cutting risk…