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Payer Issues

Cigna posts $1.2B Q4 profit | CMS floats universal quality measures | Payers with most MA prior auth denials | Amazon, Optum, CVS Health: Who will be 2023's biggest disruptor? | 29 burned out specialties, ranked | 9 prior auth updates

February 3, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Cigna posts $1.2B profit in fourth quarter Full story 2. Payers with most Medicare Advantage prior authorization requests, denials Full story 3. CMS proposes universal quality measures across all programs Full story…

More layoffs at Bright Health | CMS signals MA 2024 payment bump | 6 most admired payers | Humana considering all options with new MA audit rule | TMA files 4th No Surprises Act lawsuit | Will payers recoup payments for fake nursing?

February 2, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. CMS proposes small bump in Medicare Advantage payments, sweeping risk adjustment changes Full story 2. Bright Health to lay off 68 employees at Minnesota headquarters Full story 3. Humana examining all…

Humana posts $15M Q4 loss | Centene to pay $66M in Indiana Medicaid settlement | How states are prepping for Medicaid unwinding | FTC unlikely to stop UnitedHealth-LHC deal | 7 reactions to CMS' new MA audit rule | 23 exec moves in Jan.

February 1, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Humana posts $15M Q4 loss, names top execs Full story 2. 23 payer exec moves in January Full story 3. Centene to pay Indiana $66M in latest overbilling settlement Full story 4. Payers…

Payers facing $4.7B MA clawback | PHE to end May 11 | CMS creating special ACA enrollment period | BCBS Ore. president to lead Kaiser region | Blue Shield Calif. launches virtual-first plan | 7 Elevance updates

January 31, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. In blow to payers, CMS implements tougher Medicare Advantage audit rule Full story 2. Biden administration to end COVID-19 public health emergency in May Full story 3. CMS creating special ACA…

The future of MA, as AHIP's president sees it | What's next for payers' pricing data? | Hospitals' worst year since COVID | Most disenrolled from Medicaid find coverage within a year | Can Calif. deliver on Medi-Cal reform? | 8 UnitedHealth updates

January 30, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Q&A with AHIP President Matt Eyles on the future of Medicare Advantage Full story 2. 'Our job is much bigger than just publishing rates': The steps ahead for payers'…

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States eye prior auth reforms | Cigna sues exec headed to CVS | FTC still probing UnitedHealth-LHC deal | Expect more Optum-hospital deals this year | Payers ranked by employee wages | Calif. inmates to get Medicaid | 5 new payer partnerships

January 27, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Majority of states looking to regulate prior authorization this year Full story 2. Cigna sues top exec following departure to CVS Full story 3. FTC reportedly looking at vertical harm theories around…

The PBMs that defied Mark Cuban's doubts | UnitedHealth invests in Appalachia | Cleveland Clinic rarely bills for MyChart | Elevance to add $4.5B revenue with La. buy | Payers with best work-life balance | ACA enrollment at record 16.3M

January 26, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Meet the 3 PBMs partnered with Mark Cuban's pharmacy Full story 2. UnitedHealth Group puts $10M behind SDOH in Appalachia Full story 3. 'A strategic acquisition': Elevance Health to see $4.5B…

Elevance posts $949M Q4 profit | Payers facing the largest MA clawbacks | BCBS plans push for site-neutral payments | Blue Shield Calif. lays off 373 | Boston Med CEO to lead Mass. HHS | AI could save payers billions: McKinsey | 7 Optum updates

January 25, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Insurers that face the largest potential Medicare Advantage clawbacks Full story 2. Elevance Health posts $949M profit in Q4 Full story 3. Site-neutral payments central to BCBS Association’s $767B savings…

Insurtechs face uncertainty in 2023 | Elevance to buy BCBS La. | FCC OKs Medicaid robocalls | CVS refreshes executive team | Amazon launches Prime for prescriptions | AHIP's 2023 State of the Industry: 7 notes

January 24, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. The elephant in the room: 'Insurtechs' aren't working Full story 2. Elevance Health to acquire BCBS Louisiana Full story 3. FCC OKs Medicaid robocalls Full story 4. 5 ways to help your…

MA scrutiny intensifies in 2023 | Lawmakers go after UPMC | Woman shoots, kills husband in Fla. hospital | NC rejects BCBS, UnitedHealth appeals of state health plan award | McKinsey's payer predictions through 2026 | 9 payer workforce moves

January 23, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Why 2023 could bring big Medicare Advantage challenges for payers Full story 2. Lawmakers go after UPMC Full story 3. Half of patients with HDHPs have received a surprise medical bill Full…

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