PHI Air Medical, an air ambulance company, suspended operations at the Red Bluff Air Medical Base at Red Bluff Airport in California amid reimbursement tensions with insurers. A Sept. 14 PHI news release shared with Becker’s specifically blamed Elevance Health,…

For too long, Medicare Advantage has rewarded plans for becoming better at documenting how sick their members are. The next era should reward them for demonstrating how much healthier they make their members. Medicare Advantage is now the dominant alternative…

SCAN Health Plan has emerged as a major Medicare Advantage partner for retailers, with Walmart now partaking in a co-branded plan. The health insurer and retailer are launching the plan in two states, according to a Sept. 16 SCAN news…

Humana and UnitedHealthcare received a combined total of $177.8 million in Medicare Advantage overpayments tied to coding that was not supported by medical records, the HHS Office of Inspector General said in separate audit reports published Sept. 15. The OIG’s…

Ten providers recently posted job listings seeking leaders in payer contracting and relations. Note: This is not an exhaustive list. Listings were compiled from job-seeker sites. 1. Adventist HealthCare, based in Gaithersburg, Md., seeks a vice president of revenue cycle…

ACA insurers requested a median rate increase of 15% for 2027, according to a Peterson-KFF Health System Tracker analysis. However, some states are pushing back — while others are abiding by those requests — as they finalize increases. The set…

Medicare Advantage now covers more than 51% of eligible beneficiaries, but for a growing number of health systems, participating in the program has become a lose-lose proposition: stay in and absorb mounting losses, or exit and hand competitors an enrollment…

Aetna’s two-year financial turnaround has taken hold following a leadership overhaul, thousands of ongoing cost management initiatives and a margin recovery plan expected to complete by 2027. “Once you get the fundamentals in place, you start getting credibility, not only…

HHS’ Office of Inspector General released a report in September detailing gaps in efforts to reduce or halt medical equipment supplier fraud in Medicare Advantage. Earlier in the month, CMS announced that it had barred 11 medical suppliers from receiving…

GoHealth will lay off 103 of the 111 full-time employees reporting to its Chicago headquarters months after the health insurance marketplace and Medicare-focused digital health company filed for bankruptcy.  The company said in a Sept. 3 WARN notice that due…