Payer

Cigna will not cover MRIs and CT scans performed in a hospital setting if they don't meet new medical necessity requirements, according to a policy that took effect Aug. 1. 

UnitedHealth Group further outlined its stances on creating the "next-generation health system," which includes attaining universal health insurance coverage, healthcare affordability and improving outcomes. 

In September, Columbia, Md.-based MedStar Health and CareFirst BlueCross BlueShield unveiled a new value-based partnership that the organizations said will save patients $400 million on healthcare costs in the next seven years.

Clover Health, the Medicare Advantage startup that is working with Walmart, entered into a definitive agreement to become a publicly traded company through a merger with a special acquisition company.

Humana released results from its value-based programs for the past year, estimating that it saved $4 billion in healthcare expenses that would have been recorded under fee-for-service models. 

M Health Fairview and CentraCare may no longer be considered in-network for Humana's Medicare Advantage members beginning next year, according to the Star Tribune.

The Blue Cross Blue Shield Association named Kim Keck its new president and CEO, effective Jan. 4. 

Payment models that tie compensation to quality and cost goals aren't often focused on disadvantaged communities, and may inadvertently create incentives for hospitals to avoid these groups and sustain structural racism, according to an op-ed published in The New York…

Here are six recent contract agreements and conflicts between payers and providers: 

Blue Cross and Blue Shield of Illinois is sending its members about $108 million in premium credits, the insurer said Oct. 6.