Payer

UnitedHealthcare and Cigna recently switched or paused policy implementations after receiving criticism from medical groups and other organizations. 

Medicare Advantage patients who receive in-home health visits through the Optum HouseCalls program spend less time in the emergency room and inpatient hospital settings, according to a study by Yale Medicine and Optum researchers.

Several carriers owned by insurtech companies significantly grew premiums written in 2022, but claims became a big challenge for two companies in particular — Bright Health and Friday Health Plans — according to a May 30 report from S&P Global. 

Oscar Health collected the highest amount of premiums from its members in 2022 among all insurtechs, according to a May 30 analysis from S&P Global.

Medicare spending per person grew by an average of 4.6 percent annually between 2000 and 2022, according to a June 6 analysis from KFF. 

A federal judge in North Carolina certified class action status June 5 in a lawsuit alleging Aetna and OptumHealth Care Solutions conspired to use "dummy code" to make administrative fees appear to be billable medical charges.

Friday Health Plans, which is going out of business, is being sued by its co-founder and former COO David Pinkert for allegedly refusing to pay his severance package after he was terminated earlier this year.

The nation's largest payers saw generally stable financial results in the first quarter of 2023 despite economic uncertainty throughout the broader healthcare industry, according to a June 6 analysis from Fitch Ratings shared with Becker's.

The average cost of addressing social determinants of health is more than double what existing federal programs will cover, according to a study published May 30 in JAMA Internal Medicine.

Humana's CenterWell Senior Primary Care business has opened its 250th center with plans to continue expanding over the next two years.