Payer

Provider groups praised proposed CMS regulations to overhaul prior authorization in Medicare Advantage, one of many proposed and final changes from the agency. Payer groups are concerned about potential star ratings changes, tougher auditing standards and potential changes to reimbursement…

BlueCross BlueShield of Tennessee is digging into the data behind health equity, publishing its first ever health equity report to bring together public data and data from BCBS Tennessee members. 

A few Medicaid managed care plans have hired or are planning to hire more staff to process Medicaid redeterminations, a survey of plans by Kaiser Family Foundation found. 

Medicare beneficiaries who enroll in a Medicare Advantage plan may need less retirement savings to cover their healthcare costs, an analysis published Feb. 9 by the Employee Benefits Research Institute found. 

Individuals aged 27 to 42 in 2023 with chronic health issues are using healthcare services at a significantly higher rate than older generations, according to a new white paper from UnitedHealthcare and the nonprofit Health Action Council.

UnitedHealthcare added a new rewards program for members who use wearable devices, and UnitedHealth Group posted big profits and revenue in 2022. 

Optum patients who are in a two-sided risk Medicare Advantage plan have better health outcomes than patients enrolled in traditional Medicare, according to a study published in JAMA Network Open.

Humana's philanthropic foundation announced grant recipients and a new advisory council as part of a new health equity strategy. 

Centene continues to lead the industry in Medicaid managed care contracts, while Humana said it plans to pick up more state contracts this year. 

Oscar Health will provide administrative services to Miami-based Associated Medical Care, the first partnership for the company's +Oscar Campaign Builder tool.