Payer

As cost and complexity grow to be "fundamental" challenges to employers looking at health insurance amid the pandemic, businesses are looking for holistic ways to manage coverage, said Tara Krauss, head of accident and health for QBE North America.

A federal appeals court ruled against UnitedHealthcare Aug. 13 in a case involving Medicare Advantage overpayments. 

The over two-thirds of workers under employer-funded healthcare plans are being swept into a dangerously growing trend, said Alain Enthoven, PhD, a Stanford emeritus professor of public and private management.

More than half of medical practices are seeing insurance fees they didn't agree to when receiving electronic payments, according to an Aug. 10 poll from the Medical Group Management Association.

Fewer payment models and a closer link between outcomes and health equity will guide CMS' strategy during the next decade, leaders wrote in an Aug. 12 blog post published in Health Affairs.

Miami-based CareMax, a senior healthcare provider with an emphasis on value-based care, penned a partnership with Anthem that will lead to the duo opening 50 medical centers around the country.

On the heels of its second-quarter earnings report, New York City-based insurance startup Oscar Health painted a bold 2022 agenda laden with expansion and supporting inclusive care.

Medicare Advantage company Alignment Healthcare on Aug. 3 announced it will expand into 16 new markets in 2022. The expansion will make the payer's plan options available to a total of 6.9 million Medicare-eligible people in 38 markets across Arizona,…

Four leading health insurance startups all reported revenue growth through 2021's second quarter, but also suffered net losses. 

Excellus BlueCross BlueShield joins the ranks of six Blue Cross Blue Shield affiliates who are refusing to cover Aduhelm, Biogen's Alzehimer's drug, without definite proof of its effectiveness.