March 24, 2025 BHR Newsletter 1. Massachusetts payer 'in very deep financial trouble' Full story 2. Why payers, employers aren't sold on GLP-1s Full story 3. 'A broad opportunity' for ACA plans on the horizon Full story 4. Member needs are evolving fast.…
Payer Issues
March 21, 2025 BHR Newsletter 1. 25 payer execs weigh in on healthcare's needed conversations Full story 2. Humana opens first Walmart clinic Full story 3. The 37 health systems Optum recommends for cancer care in 2025 Full story 4.…
March 20, 2025 BHR Newsletter 1. Ohio payer beats UnitedHealthcare in racketeering lawsuit, awarded $50M Full story 2. Humana, Aledade expand partnership to FQHCs, rural providers Full story 3. Optum shakes up pharmacy reimbursement model Full story 4. Baptist MD…
March 19, 2025 BHR Newsletter 1. Optum to eliminate prior authorization for 80 drugs Full story 2. Cigna, HCSC close $3.3B Medicare Advantage sale Full story 3. Molina's 5 highest-paid executives in 2024 Full story 4. NCQA credentialing changes are coming…
March 18, 2025 BHR Newsletter 1. JPMorgan sued by employees over PBM relationship with CVS Full story 2. California bans "sham" health plans, reaches $1.3M settlement Full story 3. Optum staff in New York vote to unionize Full story 4. Don't…
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March 17, 2025 BHR Newsletter 1. Cigna's 5 highest-paid executives Full story 2. Nevada to award Medicaid contracts Full story 3. CMS doubles down on Medicare drug price negotiations Full story 4. Faster, smarter data management is within reach — how…
March 14, 2025 BHR Newsletter 1. MedPAC estimates $84B in Medicare Advantage overpayments in 2025: 10 notes Full story 2. Highmark Health Plans reports $166M loss, cites GLP-1s as headwind Full story 3. 10 payers recently fined by states Full…
March 13, 2025 BHR Newsletter 1. Cigna names COO, CFO in executive shuffle Full story 2. BCBS Massachusetts latest to sue CMS over Medicare Advantage star ratings Full story 3. CMS to end 4 Medicare payment programs early Full story…
March 12, 2025 BHR Newsletter 1. Blue Shield of California CEO exits after 2 months Full story 2. Molina pays $40M to settle alleged Medicaid violations in whistleblower lawsuit Full story 3. North Carolina insurer to wind down operations Full…
March 11, 2025 BHR Newsletter 1. The pharmacy change 'key to your future existence as a health plan' Full story 2. CMS pitches shortening ACA enrollment period: 5 things to know Full story 3. Illinois awards 4 D-SNP contracts Full…