Payer

With an estimated 65 million Americans covered under value-based care plans by 2025, payers are making big investments in care delivery models that focus on quality over quantity. From partnerships with providers to billion-dollar purchases of home care services, these…

Bingham Farms, Mich.-based United Physicians and Agilon Health have entered a long-term partnership to transition United's primary care delivery system for Medicare Advantage patients to a full-risk value-based care model.

Portland, Maine-based Fore River Urology is terminating its contract with Anthem, Maine Public Radio reported May 2. 

Government Accountability Office head Gene Dodaro appointed four new members to the Medicaid and CHIP Payment and Access Commission May 2. 

Four House lawmakers said it is "well past time to bring prior authorization into the 21st century," following an HHS report on Medicare Advantage denials.

Centene CEO Sarah London addressed alleged issues with Magellan's Medicaid pharmacy benefits rollout in January during the company's first-quarter earnings call April 26.

UnitedHealthcare plans will only pay for the controversial Alzheimer's drug Aduhelm for patients in clinical trials who have received prior authorization, according to a medical policy update filed May 1.

The Massachusetts Supreme Court approved a $236 million merger between UnitedHealth Group subsidiary Optum and Atrius Health on April 29, Atrius Health confirmed to Becker's.

America's Health Insurance Plans is criticizing an April 27 report from the HHS Office of Inspector General that found Medicare Advantage Organizations sometimes delayed or denied enrollees' access to services even though the request met Medicare coverage rules.

Kentucky and Oregon are creating basic health plan programs to make coverage more affordable to low-income residents, Politico reported April 30.