Payer

Oscar Health published a glimpse into how the payer uses AI. 

Health plans for state employees are often the largest commercial healthcare purchasers in their state, but these bargaining powers are not translating to lower costs, according to a report from the Center on Health Insurance Reforms at Georgetown University in…

Medicare Advantage beneficiaries with three common chronic conditions spend less time in the hospital than their counterparts in fee-for-service Medicare, an industry-backed report found. 

Michigan said it would pause Medicaid disenrollments through July, and more states could follow, The Washington Post reported June 29. 

Centene CEO Sarah London says behavioral healthcare services are one of the areas where costs are growing the fastest.

No single source of information exists where consumers can view how often a specific health plan denies coverage for in-network and out-of-network claims, but state and federal agencies have the ability to change that, according to a June 28 ProPublica…

Select Health, the nonprofit insurance arm of Salt Lake City-based Intermountain Health, has rebranded with a new color palette, logo, and adjustment of its name, which was formerly SelectHealth.

A majority of health plans and employers are considering at least one measure to change cost-sharing for prescription drugs, according to a report from the Pharmaceutical Strategies Group. 

Elevance Health said it will acquire Blue Cross Blue Shield of Louisiana in 2023, and the payer delivered double-digit growth in the first months of 2023. 

Recent research on Medicare Advantage found enrollees with chronic conditions are not more likely to switch to original Medicare, and payment cuts do not slow the program's enrollment growth.