Payer

There is a wide variation in Medicaid disenrollment rates across reporting states, ranging from 82 percent in Texas to 10 percent in Michigan, according to a July 24 KFF report. 

California will use an $82.5 million investment to eliminate deductibles and reduce copays for some of its Covered California plans. 

Recent studies have uncovered differences between networks, beneficiary characteristics and medications prescribed in Medicare Advantage and fee-for-service Medicare. 

Common misconceptions about prior authorizations include how they are decided and their purpose, payer executives told Becker's.  

Short-term insurance plans can be valuable for those comfortable with high-deductibles in need of basic coverage, Victoria Eardley wrote in a July 21 opinion for The Wall Street Journal. 

Physicians who serve more patients dually eligible for Medicare and Medicaid and with higher risk scores are less likely to be included in Medicare Advantage networks, a study published July 21 in JAMA Health Forum found. 

Employer-sponsored insurance plans with fully-integrated medical and pharmaceutical benefits can lower medical costs and reduce hospitalization and emergency room visit rates, according to a report from Blue Cross Blue Shield of Minnesota and Prime Therapeutics. 

The CEO of a laboratory company acquitted in a $1.4 billion fraud scheme is suing six payers, alleging they made false allegations to regulators and prosecutors to avoid paying millions in legitimate claims.

Elevance Health beat investor expectations in its latest earnings report and is adding new food-as-medicine initiatives. 

The neighborhood an individual lives in can affect their healthcare utilization, especially in the Medicare population, according to a study in the American Journal of Managed Care.