Payer

The U.S. House of Representatives unanimously passed a bill Sept. 14 to reform the Medicare Advantage prior authorization process. 

From Medicare Advantage expansions nationwide to partnerships with providers on health plans, these are eight recent payer moves to enter new markets:

A majority of healthcare executives think value-based-care has replaced fee-for-service billing, a new survey found. 

Sana, a health insurance startup offering plans to small businesses, is expanding to Alabama. 

NextBlue of North Dakota is continuing to expand its Medicare Advantage plans, NBC/FOX affiliate KFYR reported. 

Blue Cross and Blue Shield of North Carolina says its value-based care program, Blue Premier, has saved its members close to $500 million over the past three years and improved care outcomes.

The Medicaid programs in Arizona, California, Kentucky, Minnesota, North Carolina, and West Virginia have been awarded the 2022 Medicaid Innovation Award by the Robert Wood Johnson Foundation and the National Academy for State Health Policy.

Enrollees in Medicare Advantage were less likely to receive low-value care than those enrolled in traditional Medicare, a new study published in JAMA Open Network found. 

Missouri is no longer seeing a Medicaid application backlog, the state's social services department director told state lawmakers, the St. Louis Post-Dispatch reported Sept. 14. 

Karen Lynch, CEO and president of CVS Health, says it's time to change the conversation around mental health — and business leaders have a role to play by supporting employees and recognizing mental health as an everyday health issue.