Payer

The employer-based health insurance landscape has seen constant readjustment over the past decade, putting firms at a decisive crossroads. 

One of the developing insurance battlefields are members who are forced to choose between paying for healthcare needs or basic needs, such as groceries, said Paul Hain, MD, CMO of GoHealth.

Texas health officials refused an offer by CMS to continue Medicaid funding for providers, according to an Aug. 16 letter obtained by Politico Pulse.

A bankrupt self-insured health plan for 2,500 physician practices and other small businesses says it doesn't have enough money to pay out medical claims, NJ.com reported Aug. 19. 

Seventy-two percent of the country's largest health plans are no longer waiving out-of-pocket costs for COVID-19 treatment, according to research released Aug. 19 by the Peterson-KFF Health System Tracker.

As employees and contractors leave their homes to work, Humana is requiring them to get vaccinated. 

Nonprofit health insurer Medica and St. Louis-based system SSM Health formed a new relationship under which Medica will invest in an insurance subsidiary of SSM.

Reno, Nev.-based Saint Mary's Regional Medical Center, which is owned by Ontario, Calif.-based Prime Healthcare, will no longer be in network for Prominence HealthFirst, the provider announced Aug. 18.

A statement from the New York State Comptroller's office claimed that the state's Department of Health allowed $1.5 billion in erroneous Medicaid payments over the past few years.

The health insurance landscape has seen a slew of new executives move about the fold.