Payer

Common medical procedures can cost more than twice as much when they take place in a hospital outpatient setting compared to a physician office or ambulatory surgery center, according to an analysis published Sept. 14 by the Blue Cross Blue…

CVS Health CEO Karen Lynch said she is "optimistic" Aetna will improve its Medicare Advantage star ratings for 2024. 

Some payers are reporting big savings with value-based care efforts. 

There is a small pool of executive candidates who can oversee millions of lives and produce positive financial results for large healthcare organizations, and payers have shown they are willing to take those executives to court when they leave for…

Reactions to Blue Shield of California's decision to drop its contract with CVS Caremark to manage pharmacy benefits in favor of a partnership with five companies have been overblown, CVS Health CEO Karen Lynch said. 

The nation's largest Latino civil rights organization, UnidosUS, along with 12 other state and national organizations, have filed a complaint with the HHS Office of Civil Rights regarding what they say is Florida's "illegal discrimination" under the Civil Rights Act…

Weight loss drugs like Ozempic and other GLP-1s exploded in popularity this year, resulting in drug shortages and increasing costs for payers and employers. 

Additional Medicaid coverage enacted during the COVID-19 pandemic helped keep the number of uninsured people down at record lows in 2022 even as poverty levels soared, according to a Sept. 12 New York Times report.

From payers announcing cuts, to a lawmaker investigation denials, here are five updates about prior authorizations Becker's reported since Aug. 17: 

Mississippi could consider Medicaid expansion next year, Mississippi Rep. Jason White told Mississippi Today.