Medica is expanding into the St. Louis region with new network partnerships that include SSM Health and Mercy. The company’s commercial plans include ACA-funded small group, level-funded, fully insured and self-insured large group options. Medica also operates in the Medicaid…
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Following a tumultuous period for UnitedHealth Group, new CEO and board chair Stephen Hemsley addressed investors on June 2, acknowledging the company’s recent shortcomings and detailing his plan to restore the high performance that investors and customers expect moving forward.…
Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, has named Patrick Gilligan as its new CEO, effective June 16. Mr. Gilligan joins Point32Health from consulting firm CWH Advisors, where he was a partner. Previously, he…
Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Baptist Health Care, based in Pensacola, Fla., seeks a director of managed care…
Aetna and Seattle-based UW Medicine facilities and physicians went out of network on June 1. Aetna’s commercial and Medicare Advantage members have lost in-network coverage at UW because no contract agreement was reached. There will be no impact to provider…
Blue Shield of California reported a net income of $103 million in 2024, down more than 20% from $130 million in 2023. In 2024, the company’s total revenue was $27.4 billion, up 8.2% year over year. The company’s operating expenses…
Medicare Advantage insurer Devoted Health has laid off 120 employees, a small percentage of its more than 2,000 employees. “Devoted Health’s recent workforce changes are in line with our ongoing commitment to dramatically improving the health and well-being of older…
Blue Cross and Blue Shield of Minnesota has dropped a Medicare Advantage star ratings lawsuit against CMS. The lawsuit, originally filed March 10 in federal court in Washington, D.C., challenged the accuracy of CMS’ calculation of the company’s 2025 MA…
New Hampshire lawmakers are moving to address surprise ambulance billing with proposed legislation that would prohibit insurers from charging patients the balance between what their insurance covers and what ambulance services bill. The bill would mandate that insurers reimburse for…
Elevance Health’s Blue Cross Blue Shield of Georgia is suing HaloMD, Hospitalist Medicine Physicians of Georgia and Sound Physicians Emergency Medicine of Georgia, alleging the three organizations exploited the No Surprises Act’s Independent Dispute Resolution process for financial gain. The…