Payer

Health insurance is a tough business to break into. 

ACA premiums are likely to rise in 2024, with most insurers proposing rate increases of between 2 and 10 percent, according to data from the KFF-Petersen Health System tracker. 

Oscar Health is accepting new members in Florida after an eight-month pause on new sign-ups in the state. 

CMS will pay Medicare Advantage plans $12.8 billion in bonus payments in 2023, according to a KFF analysis published Aug. 9. 

A new trial that showed weight-loss drug Wegovy has benefits for cardiovascular health could make it more difficult for insurers to justify not covering the drugs, columnist Lisa Jarvis wrote in Bloomberg Aug. 8. 

Oscar Health posted a $15.4 million loss in the second quarter of 2022, down from a $112.1 million loss in the same period last year, according to the company's earnings report published Aug. 8. 

You would be hard-pressed to find a payer or provider that doesn’t believe healthcare data interoperability is essential; surveys of healthcare leaders have shown that interoperability is a top priority for a majority of organizations across the healthcare industry. Healthcare…

Patients enrolled in BlueCross BlueShield of Illinois Medicaid can access all OSF HealthCare hospitals and physicians as part of their insurance plan, effective Aug. 8. 

Medicare Advantage enrollment is highly concentrated among a small number of payers, with just two payers accounting for 47 percent of all enrollees in 2023, according to an Aug. 9 analysis from KFF.  

A study of Blue Cross Blue Shield claims data from five states found price increases were a bigger contributor to rising emergency room costs than upcoding.