Payer

The nation's largest payers have filed their third-quarter earnings reports, revealing which grew their revenues and net incomes the most year over year. Individual BCBS company revenues and profits in the first half of 2023 are also available.

Medicare Advantage enrollees have 70% lower hospital readmission rates than their counterparts in fee-for-service Medicare, a white paper from researchers at Boston-based Harvard Medical School and software firm Inovalon found. 

Eighty percent of patients in the U.S. with insurance coverage who are taking Novo Nordisk's weight loss drug Wegovy pay less than $25 a month for the drug, CNBC reported Nov. 2. 

Humana PPO payment rates for diabetes with complications ranged from $31,998 for Houston-based Memorial Hermann to $6,376 for Johnson City, Tenn.-based Ballad Health, according to data compiled by Hospital Pricing Specialists.

More than 10 million people have been disenrolled from Medicaid since continuous coverage requirements ended in April, according to KFF. 

Vice President Kamala Harris said that while artificial intelligence has the potential to do profound good, it also has the potential to cause profound harm, and that potential for harm includes actions by health insurance companies. 

The Cigna Group raised its year-end revenue projections to $192 billion, according to the company's third quarter earnings published Nov 2.

An increase in COVID-19 inpatient admissions is one factor driving higher utilization rates in Medicare Advantage, Humana executives said. 

With open enrollment underway, Centene's Ambetter from Sunshine Health, the payer's ACA subsidiary in Florida, is adding Walmart Health centers to its preferred provider network.

Humana reported a 30% decline in net income year over year in the third quarter of 2023.