Payer

Medicare Advantage enrollment has grown rapidly in recent years, now enrolling over half of Medicare eligibles. But payers shouldn't expect the growth to last forever, analysts for McKinsey and Company say. 

Health Care Service Corporation, which operates Blue Cross Blue Shield affiliates in Illinois, Texas, Oklahoma, Montana and New Mexico, is expanding AI technology to speed up prior authorization. 

Health insurers around the country are looking to raise premiums next year in part to meet the high demand for expensive weight-loss drugs such as Ozempic.

The vast majority of health insurers have a presence across social media sites, and some have made the jump to the newest platform, Threads, a Twitter competitor from Facebook's parent company, Meta Platforms.

Payers use claims data, member demographics and more to uncover new findings. 

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.