Payer

Payers should start evolving their strategies to be digital first, and streamline administration to respond to headwinds in the Medicare Advantage market, analysts for McKinsey and Company said in a July 11 report. 

Excellus BlueCross BlueShield received an estimated $5.4 million in Medicare Advantage overpayments in 2017 and 2018, according to an audit from HHS' Office of Inspector General. 

The Medicaid redetermination process is off to a poor start, according to Adrianna McIntyre, PhD, an assistant professor of health policy and politics at Boston-based Harvard T.H. Chan School of Public Health.

Five of the 10 drugs with the highest Medicare Part D spending are diabetes treatments, including Ozempic, according to an analysis from KFF. 

Johns Hopkins HealthCare, the insurance arm of Baltimore-based Johns Hopkins Medicine, is rebranding as Johns Hopkins Health Plans. 

The Cigna Group named a new leader for its Medicare business and settled several legal actions in recent weeks. 

From specialty Medicare Advantage plans to continued investment in care delivery services, these are six payers entering new markets, as reported by Becker's since April 1:

The Minnesota Department of Commerce has fined Medica $300,000 and imposed a two-year monitoring period for what it says are violations of mental health parity laws.

Price transparency data is available, but several changes are needed to actually bring about lower healthcare costs, researchers at Washington, D.C.-based Georgetown University's Center for Health Insurance Reforms wrote. 

Two nonprofit Blue Cross Blue Shield companies will reorganize this year, hoping to stay competitive with for-profit rivals like UnitedHealth Group and Aetna.