CVS Health, parent company of Aetna, posted $2.1 billion in first quarter profits. The payer will also have a new executive taking the helm in September.
Payer
American Medical Association President Jack Resneck Jr., MD, detailed in a post on the medical group's website the "Kafkaesque" prior authorization process that an unnamed insurance company allegedly put one of his patients through.
Medicare Advantage directories are plagued with inaccuracies, particularly for mental health providers, the Senate Finance Committee Chair Ron Wyden said.
UnitedHealth Group CEO Andrew Witty had the largest percentage increase in compensation between 2021 and 2022, according to regulatory filings.
Eight-four percent of group practices surveyed said prior authorization requirements have increased for Medicare Advantage over the past year, while less than 1 percent said those requirements have decreased, according to a May 3 survey from the Medical Group Management…
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CVS Health is expecting big growth in its Medicare Advantage membership by the end of 2023, setting a different tone compared to the company's disappointment in "low- to mid-single-digit-percentage" growth late last year.
Ochsner Health Plan is now a member of the Alliance of Community Health Plans, which represents nonprofit, vertically-integrated health plans across 38 states and Washington, D.C.
Payers face multiple industry headwinds, ranging from healthcare worker shortages to the high prevalence of chronic conditions, disjointed member experiences and disengaged members. These headwinds result in gaps in care, unnecessary emergency department (ED) readmissions and other issues.
Forcing states to implement Medicaid work requirements would fail basic constitutionality tests, a group of health policy experts wrote in Health Affairs.
Pennsylvania Gov. Josh Shapiro signed legislation May 1 that will require all payers operating in the state to eliminate any out-of-pocket costs for annual breast cancer screenings and genetic testing for high risk individuals.