Payer

Both CVS Health and Humana contend with rising inpatient costs in Medicare Advantage, but each points to different causes for the increases. 

Medicaid redeterminations began in April 2023, and all major payers have released their second quarter 2024 earnings, revealing which have recorded the largest enrollment losses in the Medicaid market since redeterminations began.

L.A. Care Health Plan has removed 24% of its prior authorization requirements. 

At least 16 states provide coverage of GLP-1 drugs for weight loss to state employees, according to data from Leverage and the Robert Wood Johnson Foundation. 

Medicare Advantage costs could rise in the second half of 2024, CVS Health CFO Tom Cowhey told investors. 

Payers are preparing an aggressive defense of their pharmaceutical benefit managers from scrutiny on Capitol Hill. 

North Carolina's Treasurer Dale Folwell is warning that the state health plan could soon be facing insolvency.

Blue Cross Blue Shield of Louisiana will rebrand as Louisiana Blue. 

Clover Health reported a net income of $7.2 million in the second quarter of 2024, the company's first-ever profitable quarter. 

Medicare Advantage insurers denied 7.4% of prior authorization requests in 2022, according to data published by KFF.