Payer

"Gold card" programs that give providers exemptions from certain prior authorization requirements have received mixed reviews from payers, according to a Nov. 14 America's Health Insurance Plans survey. 

Genetic testing, specialty drugs and high-tech imaging are some of the most common treatments that require prior authorization, according to a Nov. 14 survey from AHIP.

Medicare Advantage premiums have risen for the first time in four years, and less enrollees are choosing $0 premium plans, according to a new report from online insurance marketplace eHealth.

Bright Health Group has granted its top executives retention bonuses in the form of equity awards, as the company ends most of its insurance business and prepares for layoffs, the Star Tribune reported Nov. 22. 

Humana is expanding its primary care business, CenterWell, and adding partnerships with new services for members. 

The National Association of Medicaid Directors has told congressional leaders that a clearer picture is needed surrounding the end of the COVID-19 public health emergency's Medicaid continuous enrollment requirement. 

Several states have implemented prior authorization reforms this year, but a majority of payers said state regulations make programs worse, according to a Nov. 14 survey from AHIP. 

More than four in five Medicare Advantage enrollees receive some kind of over-the-counter benefits, according to an analysis from Kaiser Family Foundation. 

Payers say the largest barrier to implementing alternative payment models is providers' reluctance to take on risk, according to a survey from the Healthcare Payment Learning and Action Network. 

Lawton, Okla. has the least competitive Medicare Advantage market in the country, according to a study from the American Medical Association published Nov. 1.