Payer

Group members of Highmark, a subsidiary of Blue Cross and Blue Shield, with integrated medical and pharmacy benefits saved an average of $150 to $230 per member, per year and had better health outcomes compared to those who used separate…

Excellus BlueCross BlueShield appointed James Reed as CEO of the nonprofit health plan and its parent company, The Lifetime Healthcare Companies.

UnitedHealthcare and Reno, Nev.-based Renown Health are attempting to reach an agreement to keep Renown in-network for UnitedHealthcare and Health Plan of Nevada members, according to a News 4 article. 

A rule that limited competition between the Blue Cross Blue Shield Association's 35 insurers is no more, a change stemming from a $2.7 billion antitrust settlement, according to The Wall Street Journal.

New York families and private-duty nurses are asking the state's Department of Health to reassess the Medicaid eligibility age of disabled children requiring at-home care.

Prior authorization is a complex, expensive and burdensome process with clinical and financial impacts across the spectrum of care. Built on processes that are mostly manual, even partial automation of submissions and other routine tasks could ease some of the…

The Choctaw Nation has sued UnitedHealth Group and CVS Health, accusing the companies of  improperly denying reimbursement for pharmacy services.

A new study shows health insurance companies overestimate patient care costs to reduce or avoid paying refunds to policyholders, according to the American Accounting Association.

In March, California handed control of the state's vaccine rollout to insurer Blue Shield. The deal, worth up to $15 million in reimbursements, was met with criticism. Blue Shield CEO Paul Markovich discussed the status of the company's vaccine involvement…

The Kaiser Family Foundation released a study on how insurers performed financially during the pandemic year. Here are eight things to know: