Payer

Competition between Blue Cross Blue Shield companies is increasing after a 2022 antitrust settlement that struck down some agreements limiting competition between BCBS Association members, according to a July 13 report from Advisory Board. 

Anthem Health Plans of Virginia and its HealthKeepers managed care unit have agreed to pay $300,000 to settle allegations from the state's insurance department that it was not paying claims as quickly as was required by law, the Richmond Times-Dispatch…

UnitedHealth Group recorded double-digit growth in revenue year over year across its lines of business at UnitedHealthcare and Optum, according to the company's second-quarter earnings report released July 14.

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.