Payer

From Humana suing HHS over a new Medicare Advantage clawback rule, to Prisma Health accusing UnitedHealthcare of breaching a confidentiality agreement, here are five lawsuits and settlements involving payers Becker's has reported since Aug. 16.  

The number of large employers choosing self-pay over fully-insured benefits has declined since 2010, according to a brief from the Employee Benefits Research Institute published Aug. 24. 

Medicare Advantage plans generally spend less per enrollee than traditional Medicare plans, but these differences vary widely by condition, a study published in the September issue of Health Affairs found. 

Medicare spending per beneficiary has remained stagnant over the past decade, but the reasons why are unclear, The New York Times reported  Sept. 4. 

Ten providers recently posted job listings seeking leaders in payer contracting and relations.

Medicare Advantage beneficiaries were less likely to receive ongoing at-home care than their counterparts in traditional Medicare but more likely to receive one-time visits, a study published in the September issue of Health Affairs found. 

Hawaii has the highest rate of private employers that offer health insurance to their employees, while Montana has the lowest, according to 2022 data published by KFF and sourced from the Agency for Healthcare Research and Quality.

Cigna Healthcare is launching a new international health benefits plan, designed for "globally mobile" older adults. 

From the first wave of UnitedHealthcare's prior authorization cuts beginning, to a federal appellate partially reviving a reprocessing case, here are six updates on UnitedHealth Group Becker's reported since since Aug. 21: 

Medicare Advantage is working for many, but it falls short for the sickest patients, according to Steven Gordon, MD, CEO of St. Charles Health System in Bend, Ore.