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Payer Issues

Is Texas' gold card rule worth its weight? | NC reaches Medicaid expansion deal | Humana, Aledade partner on senior care | Oak Street posts $510M loss | States ranked by 2023 MA enrollment

March 3, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Texas' gold card prior authorization rule not worth its weight so far Full story 2. Walmart Health to add 28 new clinics by 2024 Full story 3. North Carolina lawmakers reach…

Feds open another PBM probe | BCBS Mich. posts $777M loss in 2022 | Who spent $1M to disparage a hospital? | Viewpoint: MA audits don't go far enough | 22 US hospitals among Newsweek's 100 best in world | 20 things to know about SNPs

March 2, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. BCBS Michigan posts $777M loss in 2022 Full story 2. Feds open another probe into PBM practices Full story 3. 20 things to know about the fastest growing form…

Biden to GOP: Don't touch federal insurance dollars | Bright Health's future in question | Apple wants to change physician, patient behaviors | MA margins far outpace other markets: Report | Cuban nets 2 million customers | CareSource, Walmart partner

March 1, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Biden to GOP: Don't touch federal insurance dollars Full story 2. Bright Health has 'substantial doubt' about company's future, posts $669M Q4 loss Full story 3. Medicare Advantage gross margins per enrollee…

MA members more likely to avoid hospitalization | BCBSA: Site-neutral Medicare payments could save nearly $500B | The 'reimbursement wars' keeping hospital execs up at night | What does Gen Z consider a high starting salary? | 15 exec moves in February

February 28, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 15 payer exec moves in February Full story 2. Medicare Advantage members less likely to be hospitalized, more likely to be shifted to other care: Study Full story 3. Medicare…

Surprise billing determinations to partly resume | Walmart Health adds executives | Humana's group exit shows allure of govt. markets | Inside Ark.'s Medicaid speed-run | Where Ozempic prescriptions are surging | MA declining in 3 states

February 27, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Some No Surprises Act payment determinations to resume Full story 2. What Humana's employer coverage exit shows about government programs' allure Full story 3. Walmart Health makes 3rd executive appointment this…

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4 changes needed beyond price transparency | Payers ranked by '22 MA growth | 16 systems partnered with One Medical | Insurers lead latest CEO trend | Aetna preps for N.C. employee plan takeover | 6 payer market exits to note

February 24, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 4 measures needed to create shoppable healthcare beyond price transparency Full story 2. Payers ranked by Medicare Advantage membership growth in 2022 Full story 3. 16 health systems that partner with…

Humana to exit employer group insurance business | MA enrollment tops 31M | Kaiser shifting 1,200 jobs out of HQ | Sens. continue 'junk' health plan fight | Feds close healthcare-sharing ministry

February 23, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Humana to exit employer group insurance business  Full story  2. Medicare Advantage enrollment tops 31 million  Full story 3. Why a Medicaid error in Tennessee could place you on…

UnitedHealth buys LHC Group | Cigna blocks former exec from new CVS role | Amazon closes One Medical deal | MA growth slows | 6 million children could lose CHIP coverage during redeterminations | States ranked by HDHP use

February 22, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealth purchases LHC Group Full story 2. Cigna's temporary restraining order bars former exec from starting CVS job Full story 3. Amazon closes One Medical deal Full story 4. From equity to…

4 major prior auth changes proposed by CMS | Payers' role in the Ozempic shortage | Cuban to partner with independent pharmacies | The best US hospital, per ChatGPT | The secret to building a 5-star MA plan | 8 Elevance Health updates

February 21, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. The major changes payers face from CMS' proposed prior authorization reform Full story 2. The insurance side of the ongoing Ozempic shortage Full story 3. Mark Cuban's low-cost pharmacy to partner…

Top 10 payers in 2023 | Most Medicaid members don't know about redeterminations | Payers, HHS spar over MA policies | Why Walgreens is shifting from pharmacies to physicians | Inside the new health equity strategy at BCBS Tenn. | 7 UnitedHealth updates

February 20, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. The 10 best health insurance companies of 2023 Full story 2. A majority of Medicaid members still don't know about redeterminations Full story 3. How Walgreens shifted its focus from pharmacies…

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