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. Baptist Health Care, based in Pensacola, Fla., seeks a director of managed care…
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Blue Shield of California reported a net income of $103 million in 2024, down more than 20% from $130 million in 2023. In 2024, the company’s total revenue was $27.4 billion, up 8.2% year over year. The company’s operating expenses…
Blue Cross and Blue Shield of Minnesota has dropped a Medicare Advantage star ratings lawsuit against CMS. The lawsuit, originally filed March 10 in federal court in Washington, D.C., challenged the accuracy of CMS’ calculation of the company’s 2025 MA…
Elevance Health’s Blue Cross Blue Shield of Georgia is suing HaloMD, Hospitalist Medicine Physicians of Georgia and Sound Physicians Emergency Medicine of Georgia, alleging the three organizations exploited the No Surprises Act’s Independent Dispute Resolution process for financial gain. The…
From its CEO’s resignation to a reported federal investigation into its Medicare Advantage business practices, May was a challenging month for UnitedHealth Group. Here are four things to know: Andrew Witty resigns UnitedHealth Group announced May 13 that CEO Andrew…
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Highmark Health Plans reported $6.1 billion in operating revenue and a $9 million operating loss in the first quarter of 2025, citing elevated utilization and continued industrywide pressures that carried over from last year. Parent company Highmark Health reported $8…
The clinical data goldmine: How HIEs are poised to transform payer efficiency & patient outcomes
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As healthcare becomes increasingly data-driven, payers are turning to clinical health record data to strengthen claims processing, care coordination and risk management. This shift reflects a broader industry trend toward more integrated, real-time data use across the care continuum. With…
Blue Cross Blue Shield of Minnesota and Blue Cross Blue Shield of North Dakota are the first two insurers to earn URAC’s Mental Health/Substance Use Disorder Parity Accreditation. The certification is the only program of its kind in the U.S.,…
Walmart is launching new digital offerings that will integrate with Medicare Advantage supplement plans. Members will be able to choose from plan-specific, benefits-eligible products while shopping online for same-day pickup or delivery in as soon as an hour, according to…
The gaps between the highest and lowest rated commercial health plans for customer satisfaction are growing, according to J.D. Power’s U.S. Commercial Member Health Plan Study. J.D. Power published its annual ranking of the top commercial health plan in each…