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5 ways Medicare Advantage, fee-for-service differ on care for chronic conditions: Report
Medicare Advantage beneficiaries with three common chronic conditions spend less time in the hospital than their counterparts in fee-for-service Medicare, an industry-backed report found. -
More states could follow Michigan in pausing Medicaid disenrollments
Michigan said it would pause Medicaid disenrollments through July, and more states could follow, The Washington Post reported June 29. -
Centene CEO: Behavioral health costs on the rise
Centene CEO Sarah London says behavioral healthcare services are one of the areas where costs are growing the fastest. -
ProPublica: No one knows how often payers deny claims
No single source of information exists where consumers can view how often a specific health plan denies coverage for in-network and out-of-network claims, but state and federal agencies have the ability to change that, according to a June 28 ProPublica report. -
Intermountain's Select Health rebrands
Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health, has rebranded with a new color palette, logo, and adjustment of its name, which was formerly SelectHealth. -
2 in 5 health plans, employers considering raising copays for prescription drugs
A majority of health plans and employers are considering at least one measure to change cost-sharing for prescription drugs, according to a report from the Pharmaceutical Strategies Group. -
10 key Elevance Health updates from the first half of 2023
Elevance Health said it will acquire Blue Cross Blue Shield of Louisiana in 2023, and the payer delivered double-digit growth in the first months of 2023. -
What 6 recent studies found about Medicare Advantage
Recent research on Medicare Advantage found enrollees with chronic conditions are not more likely to switch to original Medicare, and payment cuts do not slow the program's enrollment growth. -
Florida removing medically complex kids from Medicaid months earlier than promised
Florida has removed some children with complex medical needs from Medicaid through the redeterminations process, some advocates and families say, according to a June 28 Orlando Sentinel report. -
3 states naming new Medicaid directors
Three states named new Medicaid directors in June: -
Former Highmark employee accused of stealing funds from member's health savings accounts
A former Highmark Health employee is facing criminal charges for allegedly attempting to or withdrawing nearly $90,000 from eight member's health savings accounts, the Pittsburgh Tribune-Review reported June 26. -
10 key Humana updates from the first half of 2023
Humana said it will wind down its commercial group insurance over the next 18 to 24 months, and it shuttered its SeniorCare clinics in the first half of 2023. -
Colorado urges providers to continue accepting Friday Health Plans
Colorado will ensure providers are paid for Friday Health Plans' members' care, the state's department of insurance said. -
Medicare Advantage enrollees with chronic conditions are not more likely to switch to traditional Medicare: Study
Medicare Advantage enrollees with more chronic conditions are not more likely to switch to fee-for-service Medicare, a study published June 26 in JAMA found. -
UnitedHealthcare warned of rising healthcare utilization rates. Is pickleball to blame?
UnitedHealthcare executives recently warned of rising healthcare utilization rates as they saw a higher-than-expected number of hip replacements, knee surgeries and other elective procedures. Analysts from UBS Group AG are suggesting that pickleball could be one factor driving the higher rate of injuries, Bloomberg reported June 26. -
65% of health plans 'very concerned' about off-label use of Ozempic, other weight loss drugs
The majority of health plans surveyed in a report by the Pharmaceutical Strategies Group said they are "very concerned" about off-label use of medications for weight loss. -
10 key Cigna updates from the first half of 2023
The Cigna Group went through a rebranding and beat investor expectations in the first half of 2023. -
Colorado cancels hearings to question payers' rates
Colorado has canceled a set of hearings meant to probe payers and hospitals over rates, after payers met the state's public option price targets. -
BCBS Massachusetts: Health inequities cost state nearly $24 billion every year
The economic burden of racial and ethnic disparities in healthcare access and quality is costing Massachusetts $23.5 billion every year across all major groups, according to a June study from the Blue Cross Blue Shield of Massachusetts Foundation and the Health Equity Compact. -
10 key Aetna updates from the first half of 2023
In the first half of 2023, CVS Health named a new leader for Aetna, and the payer acquired key contracts in North Carolina and New York City.
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