Payer

These are 18 recent policy changes made by CMS that have been reported by Becker's since Jan. 1:

Medicare Advantage differs from traditional Medicare in several aspects of care quality and cost, research published in the last year shows. 

Medicare Advantage plans are not required to identify when payments claims were denied, hindering fraud, waste and abuse investigations, according to a new report from HHS' Office of Inspector General. 

Humana and Aledade are partnering for 10 years on value-based primary care for seniors, which includes a path to full-risk agreements.

A majority of the nation's largest health systems and payers have filed their fourth quarter earnings reports. Becker's has compiled their year-end net profits and losses to examine where the healthcare financial landscape stands among the largest players as of…

Excellus BlueCross BlueShield posted $58.9 million in profits in 2022, a 50 percent decline in net income from 2021. 

Healthworx, the innovation and venture capital arm of CareFirst BCBS, and Baltimore-based LifeBridge Health have selected eight healthcare startups to participate in their 1501 Health Incubator program.

As budget fights continue in the nation's capital over funding of public insurance programs like Medicare and the ACA, work requirements for Medicaid have once again resurfaced in potential proposals.

Medicare Advantage enrollment is on the rise, but the pace of growth slowed in 2022. As enrollment climbs, CMS is considering a slew of policy changes, which some groups say could cut benefits. 

Blue Cross Blue Shield of Michigan reported a $777 million loss for 2022, driven in part by the ongoing cost of the COVID-19 pandemic and pricing pressures in Medicare Advantage.