Payer

Redeterminations could be shaking up margins in the Medicaid business, payer executives warn. 

Members' satisfaction with their commercial health plans has improved since last year, but the divide between the highest and lowest performing plans is getting bigger, according to J.D. Power's annual Commercial Member Health Plan Study published May 29. 

Overall satisfaction with commercial health plans is up from 2023, but the gap between top-performing and low-performing plans is widening, according to the J.D. Power annual Commercial Member Health Plan Study published May 29. 

From its Optum arm acquiring 10 Minnesota behavioral health clinics to shuffling its top legal lineup, here are 15 updates on UnitedHealth Group Becker's has reported since May 14: 

As some major Medicare Advantage insurers look to shrink enrollments and exit markets, others say reimbursement cuts from CMS are a chance to refocus strategies and provide a better product to their members.

From two new CEOs to year-end financial earnings, these are 10 key updates about Blue Cross Blue Shield companies recently reported by Becker's:

In 2024, 36 states offered Medicare Advantage plans to retired employees, according to a report from KFF published May 23. 

From two states passing reform laws to an Oregon health system making prior authorization 'a thing of the past' for cancer treatment, here are five prior authorization updates Becker's has reported since  

The chair of the Senate Finance Committee is urging CMS to do more to stop fraud on ACA exchanges, KFF Health News reported May 21. 

UnitedHealth Group said a proposed class-action lawsuit alleging an AI algorithm wrongfully denied Medicare Advantage patients care should be dismissed because "plaintiffs have failed to exhaust the exclusive administrative appeal process set by the Medicare Act for challenging coverage determinations."