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Medicare Advantage plans received $1B for veteran enrollees using no benefits: Study
Medicare Advantage plans were paid more than $1 billion for veterans who did not use any Medicare services, according to a study published in the November issue of Health Affairs. -
7 prior authorization updates
From Blue Shield of California partnering with Salesforce to a Senate report accusing Medicare Advantage plans of intentionally using prior authorization to boost profits, here are seven prior authorization updates Becker's has reported since Oct. 1: -
States ranked by employer-sponsored health coverage
Utah had the highest percentage of residents covered under employer-sponsored health plans last year, according to an analysis from KFF. -
Payers push into home health: 5 things to know
Payers are expanding their reach into home healthcare. -
Why a 5-star Medicare Advantage plan takes a 'grassroots' approach to marketing
Alignment Health is one of the highest-quality Medicare Advantage plans in the nation, a distinction attributed to a company-wide commitment to exceptional care and performance tracking. -
BCBS Minnesota settles with state over mental health access
Minnesota's Attorney General has reached a settlement with Blue Cross and Blue Shield of Minnesota regarding accessibility of mental health services. -
Elevance Health latest insurer to sue over Medicare Advantage star ratings
Elevance Health is the latest insurer challenging CMS' 2025 Medicare Advantage star ratings. -
Aetna, Elevance, Cigna cut some Medicare Advantage broker payments
At least three major insurers are eliminating broker commissions for some Medicare Advantage plans. -
What's new for ACA enrollment: 3 notes
Open enrollment for individual plans on the ACA exchange begins Nov. 1. -
8 recent payer lawsuits, settlements
From star rating lawsuits to a record antitrust settlement, here are eight lawsuits, settlements and legal developments involving payers that Becker's has reported since Oct. 3: -
Cigna posts $739M profit despite $1B VillageMD loss
The Cigna Group posted a net income of $739 million in the third quarter of 2024, which included a non-cash after-tax investment loss of $1 billion related to VillageMD, according to its Oct. 31 financial report. -
Humana braces for tougher Medicare Advantage star ratings environment: 5 notes
Humana is upping its investments in its Medicare Advantage star ratings performance, CEO Jim Rechtin said. -
5 updates on the 2-midnight rule
From a report suggesting that some payers have "hit the snooze button" on the new guidance, to a Humana leader expressing confidence that the company is applying the rule correctly, here are five updates on the two-midnight rule that Becker's has reported since Oct. 23: -
Centene in the headlines: 10 updates
From challenging CMS' Medicare Advantage star ratings to completing the sale of another subsidiary, here are 10 updates on Centene that Becker's has reported since Sept. 11: -
Humana: Why payers, providers aren't aligned on 2-midnight trends
Humana has seen stable inpatient trends in the second and third quarters of 2024, according to CEO Jim Rechtin. -
Humana posts $480M profit in Q3
Humana reported $480 million in net income in the third quarter of 2024, down 42% since the same period last year, according to its third quarter earnings report published Oct. 30. -
States ranked by average ACA benchmark premium
Vermont has the highest average ACA benchmark premium for 2025 coverage, while New Hampshire has the lowest, according to KFF. -
What 10 Medicare Advantage insurers earn from health risk assessments
UnitedHealth Group brought in an estimated $3.7 billion in payments linked to health risk assessments and chart reviews in 2023, according to an audit published by HHS' Office of Inspector General. -
Limited health literacy is a $4.8 billion dollar issue for payers — Here's how we address it
You can think about health literacy in three ways — personally, digitally and organizationally. -
Sachin H. Jain: Why a lawsuit over Star ratings is one of the proudest achievements of my career
The other day, I had a conversation with a colleague I've worked with for years. He's familiar with my career, and he was utterly surprised when I told him that one of my proudest achievements is the lawsuit that my company, SCAN, filed against the Centers for Medicare and Medicaid Services (CMS) challenging our Medicare Advantage Star rating.
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