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Medicaid in the headlines: 10 recent updates
Georgia is implementing work requirements for Medicaid, and other states could follow. -
Molina, Elevance Health Medicaid membership grew by over 50% during continuous enrollment
Molina Healthcare had the largest gains in Medicaid enrollment during the COVID-19 pandemic, according to a report from KFF published July 6. -
'Look-alike' dual eligible plans are misleading Medicare Advantage enrollees, researchers say
"Look-alike" dual eligible Medicare Advantage plans — which primarily enroll people eligible for Medicare and Medicaid but are not regulated as D-SNP plans — grew significantly from 2013 to 2020, a study published in the July issue of Health Affairs found. -
Many Medicare Advantage beneficiaries have few choices for psychiatrists
Many Medicare Advantage plans have narrow networks for psychiatrists when compared to Medicaid managed care and ACA plans, a study published in the July issue of Health Affairs found. -
7 recent payer lawsuits, settlements
From Kraft Heinz employees suing Aetna for alleged claims data mismanagement, to the Supreme Court upholding a decision to dismiss a whistleblower lawsuit against a UnitedHealth Group subsidiary, here are seven lawsuits and settlement involving payers Becker's has reported since June 7: -
Eli Lilly overtakes UnitedHealth Group as world's largest healthcare firm
Eli Lilly is now the largest healthcare company in the world by market value, surpassing UnitedHealth Group, Bloomberg reported July 5. -
Ohio seeking Medicaid work requirements
Ohio Gov. Mike DeWine signed the state's budget, which includes language requiring the state to ask the federal government if it can impose Medicaid work requirements, cleveland.com reported July 6. -
Budget battle could delay North Carolina's Medicaid expansion
Squabbles over the state's budget could delay implementation of Medicaid expansion in North Carolina. -
How Elevance Health achieved a 20% drop in suicide rates among young people
Elevance Health has achieved a drastic reduction in youth and young adult suicides through predictive modeling and clinical outreach. -
10 providers seeking payer contracting talent
Ten providers recently posted job listings seeking leaders in payer contracting and relations. -
Medicare Advantage profits could be under pressure in 2024, analysts say
Medicare Advantage profits will likely be stable in 2023 but could face pressure from rising utilization rates in 2024, according to commentary from AM Best published June 30. -
Kraft Heinz sues Aetna for alleged claims data mismanagement
A Kraft Heinz Co. employee benefits group representing employees, retirees and their dependents is suing Aetna for allegedly breaching its fiduciary duties and using its role as third-party claims administrator "to enrich itself to Kraft Heinz's detriment." -
Medicare Advantage in the headlines: 7 recent updates
New regulations for inpatient services in Medicare Advantage are looming, and new research has found MA enrollees with chronic conditions are likely to stay enrolled in the programand spend less time in the hospital than their fee-for-service counterparts. -
States with the largest employee health plans
State employee health plans are often the largest commercial purchaser of healthcare in each state, according to a report from the Center on Health Insurance Reforms at Georgetown University in Washington, D.C. -
Medicare Advantage enrollees less likely to receive risky medications: Study
Medicare Advantage members are less likely to be prescribed high-risk medications than their counterparts in fee-for-service Medicare, a study published June 27 in JAMA Health Forum found. -
BCBS Arizona launches primary care subsidiary
Blue Cross Blue Shield of Arizona has launched a new primary care company, Prosano Health Solutions. -
Georgia's Medicaid work requirement program starts July 1: 5 things to know
Georgia's Medicaid work requirement program is set to begin July 1. Here are five things to know about the program: -
BCBS Association sues Texas company over blue cross logo
The Blue Cross and Blue Shield Association is suing a specialty care management company in Texas for using a logo it says infringes upon and dilutes the BCBS brand. -
Why Oscar Health published its AI prototypes
Oscar Health published a glimpse into how the payer uses AI. -
Why state employee health plans struggle to contain costs: 5 things to know
Health plans for state employees are often the largest commercial healthcare purchasers in their state, but these bargaining powers are not translating to lower costs, according to a report from the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.
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