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Payer Issues

Top commercial plans of '23 | UnitedHealthcare scraps new GI policy | Medicaid losses for procedural reasons in 5 states | Hospital margins break even | NYC retirees challenge Aetna MA plan

June 1, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UnitedHealthcare backs off controversial GI prior authorization policy Full story 2. The commercial health plan members are most satisfied with in each US region, per J.D. Power Full story 3. Percentage…

CMS addresses Medicaid losses | States ranked by MA members | What experts think about the size of CVS, UnitedHealth | NC clears BCBS restructuring | Ill. to build state exchange | Debate continues over UnitedHealth's GI policy | 21 exec moves in May

May 31, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. CMS: 'Substantial' portion of Medicaid terminations due to red tape Full story 2. 21 payer exec moves in May Full story 3. States ranked by total Medicare Advantage members Full story 4. Only…

Medicaid work rules a no-go | Payer mix in every state | Hospitals with best commercial rates for mental healthcare | CVS, Amazon shuttering health businesses | Elevance's 'secret sauce' to boosting maternal outcomes | Payers ranked by Medicaid members

May 30, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. The payer mix of each state in 2023 Full story 2. Medicaid work requirements axed from debt ceiling deal Full story 3. 100 hospitals with the best private payer rates for…

Avg. hospital payer mix by state | Walgreens wants $642M Humana award vacated | CVS expects $1B revenue drop | 8 best payers for new grads | Where UPMC Health Plan is growing | CBO: Uninsured rate at 10% by 2033

May 26, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Average hospital payer mix in every state Full story 2. Walgreens wants Humana's $642M arbitration award vacated Full story 3. 8 payers among Forbes' best employers for new graduates in 2023 Full…

June 1 Medicare payments at risk | 8 BCBS affiliate earnings in '22 | 1 in 4 Medicaid enrollees don't know where to find other coverage | AHIP president resigning | Harvard Pilgrim reports ransomware attack | BCBS Neb. names CEO | 8 Cigna updates

May 25, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. June 1 Medicare payments at risk if debt ceiling not resolved Full story 2. Many Medicaid beneficiaries don't know where to find other insurance: 5 notes Full story 3. How 8…

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CMS pitches PBM price transparency | Payers ranked by Q1 commercial members | Debt ceiling talks focus on Medicaid work rules | 8 most community-minded insurers | Ozempic pill sees 15% weight loss | Virtual-first health plans: 4 updates

May 24, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. CMS proposes rule to improve Medicaid and PBM price transparency Full story 2. Payers ranked by commercial membership | Q1 2023 Full story 3. 8 payers among Points of Light's most…

Employers wary of weight loss drugs | How UnitedHealth came to dominate healthcare | Calif. pitches Medicaid boost | Cigna delays modifier 25 policy | Centene COO retiring | Bright completes reverse stock split | 6 MA study findings

May 23, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 22% of employers will cover weight loss drugs: Survey Full story 2. How UnitedHealth Group became the nation's largest healthcare company Full story 3. California governor pitches higher Medi-Cal rates Full story…

Medicaid unwinding off to rocky start | 6 limitations with price transparency data, per Elevance | 175 groups oppose UnitedHealth's GI prior auth policy | Lawmakers press payers on MA claims denials | Top earners at for-profit health systems

May 22, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Medicaid redeterminations are going worse than expected, experts say Full story 2. 6 limitations with payers' price transparency data, per Elevance Health researchers Full story 3. 175 groups urge UnitedHealthcare to…

1:1 with Dr. Jaewon Ryu on Risant Health | US debt ceiling breach may be catastrophic for payers | UPMC faces antitrust suit | Optum's former CMO joins WelbeHealth | Top conditions driving self-insured claims | Unhealthiest county in each state

May 19, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'An opportunity to enhance our model': Geisinger CEO Dr. Jaewon Ryu on Risant Health Full story 2. Why a US debt ceiling breach could be catastrophic for hospitals, payers Full…

5 new Risant Health details | FTC expands PBM probe | 'Medicare for All' bill reintroduced | From PE to bankruptcy: Envision's last 5 years | Payers expect $1.1B in MLR rebates | BCBS Mass. adds physician groups | Unhealthiest states for seniors in '23

May 18, 2023 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. New Risant Health details emerge: 5 notes Full story 2. FTC expands PBM probe Full story 3. From private equity to bankruptcy: Envision's last 5 years Full story 4. A no-surprises approach…

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