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Payer

Health plans have historically struggled to deliver personalization that increases member engagement, improves care coordination, drives better outcomes and reduces costs. That’s despite spending 10% or more of their administrative budget on care management, according to McKinsey & Company, which…

More than 5 million people have been disenrolled during the Medicaid redeterminations process. In some states, Medicaid recipients have filed legal challenges to the process, and whistleblowers are raising alarms. 

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Cincinnati-based Bon Secours Mercy Health is suing Anthem Blue Cross Blue Shield of Virginia for $93 million, alleging the payer owes the health system millions in unpaid claims, according to a lawsuit filed in a Virginia circuit court.

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