Payer

South Dakota voters passed a Medicaid expansion measure in November, but now state lawmakers are proposing a ballot issue that would add work requirements to that expansion, CBS affiliate KELO reported Jan. 23. 

Payers' stocks, which remained strong through 2022, could take a hit in 2023 as the Federal Reserve relaxes interest rate hikes and federal regulators tighten rules around Medicare Advantage, The Wall Street Journal reported Jan. 23. 

Georgia will not consider a full expansion of Medicaid in the near future, The Atlanta Journal-Constitution reported Jan. 19. 

From payers diving deeper in social determinants of health to expanded payer-provider models, these are six payer partnerships reported by Becker's since Dec. 15:

A plan to shift New York City retirees' coverage to Medicare Advantage has stalled indefinitely, the New York Daily News reported Jan. 19. 

The overall insured rate in the U.S. rose between 2019 and 2021, with some states outpacing the national average growth in the insured rate of .7 percent, according HHS data. 

Cigna's pharmacy benefit manager Express Scripts' St. Louis (Mo.) County headquarters has been sold for $36 million just as the company renewed its lease, the St. Louis Business Journal reported Jan. 18. 

CenterWell, Humana's primary care organization, is opening three new clinics in Charlotte, N.C., focused on care for older adults. 

Integrating medical, pharmacy and behavioral benefits led to savings for employers, a study from Cigna found. 

While increased utilization and labor costs will be short-term challenges for payers, profits will continue to grow through 2026, according to an analysis from McKinsey published Jan. 9.