Payer

A group of Republican lawmakers are asking CMS to reconsider its proposed 2025 rates for Medicare Advantage. 

There are few statistically significant differences between the way primary care physicians treat patients in Medicare Advantage and fee-for-service Medicare, according to the Commonwealth Fund. 

From chronic disease management to mental health investments, these are 10 partnerships announced by health insurers within the last year:

Georgia's alternative to expanding Medicaid under the ACA has cost $26.6 million through Dec. 31, with 90% of that money going toward administrative and consulting costs, KFF Health News reported March 20.  

States and CMS can increase their oversight of denials by Medicaid managed care organizations, according to a report from the Government Accountability Office. 

Meridian Health Plan of Illinois will reimburse a portion of the certification fees for hospitals that participate in The Joint Commission's Health Care Equity Certification. 

UnitedHealthcare and New York City-based Mount Sinai reached a multiyear contract agreement March 19, effective immediately, after a monthslong contract dispute. 

Kaiser Permanente is the best U.S. health insurance company in 2024, according to Insure.com's annual ranking.

Highmark Health posted an operating income of $533 million on revenues of $27.1 billion in 2023, bolstered by membership growth in its health plans, the company said. 

CMS will introduce a new payment model designed to spur innovation in primary care for Medicare beneficiaries.