Payer

Humana will join a group purchasing organization operated by Cigna, according to Bloomberg.

Humana partnered with DispatchHealth, a provider of in-home medical care, to offer Humana members access to 24/7 medical care outside of the hospital, according to a Feb. 1 news release.

Anthem entered into an agreement with InnovaCare Health to buy its Puerto Rico-based Medicare Advantage and Medicaid subsidiaries, according to a Feb. 2 news release. 

The following payer executive changes were announced in January.

Cigna will no longer require prior authorization for some CT scans of the heart, according to an updated precertification list. The change is effective Feb. 1.

Attorneys general from 18 states called on the U.S. Supreme Court to allow Arkansas to set work requirements for Medicaid members, a policy that was championed by the Trump administration, according to the Arkansas Democrat-Gazette.  

Within its value-based Blue Premier initiative, Blue Cross and Blue Shield of North Carolina launched a program focused on lowering costs and improving outcomes for kidney care, the insurer said Jan. 28. 

UnitedHealth Group made another investment in affordable housing projects in Illinois and Louisiana Jan. 29, weeks after it invested in a similar project in Minnesota. 

While Anthem's fourth-quarter financial results may have disappointed investors, the insurer's in-house pharmacy benefit manager — IngenioRx — saw significant growth in the final quarter of 2020, according to recent financial filings. 

Given unpredictable volume, changing CMS regulations and varying service agreements, managing health insurance appeals and grievances (A&G) is a time-consuming and complex process, especially when done manually.