Payer

Few consumers have heard the term value-based care, a survey from EmblemHealth found. 

Pittsburgh-based UPMC's insurance services division grew membership 11 percent in the first six months of 2023 compared to the same period last year, but operating income declined by $74 million.

As more employers switch to offering healthcare benefits to retired employees through Medicare Advantage, lawmakers are eyeing legislation to require employers to offer retirees a choice between traditional Medicare and MA. 

Health systems have considered dropping Medicare Advantage plans, and insurers are making efforts to cut back on prior authorizations in the program. 

A judge sided with retirees opposed to the implementation of New York City's plan to switch 250,000 retired city employees from traditional Medicare to Medicare Advantage. 

UnitedHealthcare has agreed to pay the HHS and OCR an $80,000 settlement for potentially  violating the HIPAA Privacy Rule's right of access provision. 

Millions of health plan members have had their personal information, including Social Security numbers and medical history, breached in a massive attack affecting hundreds of organizations. 

Demand for behavioral healthcare is on the rise. 

Cigna is rolling back prior authorizations and adding new AI-based offerings for members. 

Humana and kidney care provider Interwell Health have reached a value-based care agreement in 13 states for most Humana Medicare Advantage HMO and PPO members living with chronic kidney disease as well as members across the country living with end-stage…