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Payer Issues

Hospital revenues plummet | HHS: No lower Medicare Part B premium in 2022 | Aetna faces class-action suit | Centene sheds office space | U of Vt. Health, UnitedHealth ink contract | Is Maryland's all-payer model replicable?

May 31, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Hospital revenues plummet Full story 2. Judge greenlights class action against Aetna over alleged disability benefits clawbacks Full story 3. Lower Medicare Part B premium won't come until 2023, HHS chief says Full…

Providers dropping Anthem | UPMC's big Q1 losses | CVS debuts virtual primary care | Viewpoint: Dominance of MA plans will change everything | CMS zeroes in on hospitals with COVID outbreaks | States are coming for PBMs

May 27, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. UPMC's big losses in Q1: 6 things to know Full story 2. CMS boosts oversight of hospitals with COVID-19 outbreaks Full story 3. State legislatures are coming for PBMs Full story 4. All IT…

Payers broke prior auth promises, AMA says | Dowling: Hospital leaders must stand up against shootings | No Surprises Act halted 2M bills | Feds want PBM crackdown | Patient complaint changes BCBS coverage | UnitedHealthcare's $13.6M denied care payout

May 25, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Michael Dowling: 'Every single US hospital leader should be screaming about what an abomination this is' Full story 2. No Surprises Act prevented more than 2M unexpected bills, study…

Walmart's 18 preferred providers | UnitedHealth embracing telehealth | Cigna accused of improper claim denials | Hospitals want spotlight on payers' record profits | Opinion: Payers need behavioral 'nudge units' | Empire BCBS opens new HQ

May 24, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Massachusetts hospitals to spotlight payers' record pandemic profits Full story 2. Former Georgia insurance commissioner indicted on fraud conspiracy charge Full story 3. The 18 health systems Walmart sends its employees…

Cleveland Clinic CFO exits for top payer job | Hospitals want DOJ probe of payer denials | Mayo's $142M operating gain | Health plan data breach affects 120K | Texas city gives insurance to all | Md. caps insulin costs | 8 contract disputes, resolutions

May 20, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Medical Mutual taps Cleveland Clinic CFO as new CEO Full story 2. Hospitals urge Justice Department to probe insurers over routine denials Full story 3. Rhode Island state hospital at risk…

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Tenet hospital's Medicare funding at risk | 3 letters behind single-payer defeat in Calif. | Private payers pay 224% more than Medicare | ChristianaCare to open Highmark-exclusive clinics | Anthem, SCL fight over rate boost | New Medicare website unveiled

May 19, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Tenet Detroit hospital at risk of losing Medicare contract Full story 2. Commercial insurers paid hospitals 224% more than what Medicare did, study finds Full story 3. CMS launches more user-friendly…

Anthem rebrand approved | Novant to buy stake in MA plan | Bright Health expands leadership team | Commercial healthcare spending: States ranked | Anthem, Northside dispute heads to Ga. Supreme Court

May 18, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Anthem shareholders vote to become Elevance Health Full story 2. Texas HHS director charged with insurance fraud Full story 3. Bright HealthCare, NeueHealth name new CEOs Full story 4.…

Single-payer Medicare bill reintroduced | Oscar hit with investor lawsuit | 10 hospitals that best avoid unneeded care | Humana to add 100 senior care clinics | PHE set to be extended | A COVID wave 'almost like omicron'

May 17, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Oscar Health concealed COVID-19 financial woes before IPO, investor lawsuit claims Full story 2. Humana partnership to invest $1.2B on 100 more value-based primary care clinics for…

Northwell offers coverage in Dominican Republic | 9 payer exec moves | How single payer would affect US: CBO | UnitedHealthcare's $100M upcoding suit can proceed | Rudeness: A care quality issue | The least insured county in each state

May 13, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. Northwell Health expands patient care to Dominican Republic citizens Full story 2. The least insured county in every state Full story 3. Congressional Budget Office: Here's what…

A bad Q1 for Oscar, Bright, Clover | 'Evil empire' nickname for UnitedHealth warranted: Lawsuit | NY creates office to regulate PBMs | Towns with highest insured rates | BCBS names HR chief | 3 top payers for diversity

May 12, 2022 BHR Newsletter Virtual Events  •  Webinars   •   Whitepapers   •   OnDemand Learning  •   Podcasts 1. 'Evil empire' UnitedHealth schemes to underpay providers, Envision suit alleges Full story 2. BCBS Association names new chief human resources officer Full story 3. Oscar Health, Bright…

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