Advertisement

Payer

CVS Health has grown from a single store to a healthcare giant, operating pharmacies, a major insurer and primary and home care clinics. 

Santa Clara Family Health Plan is pushing back against Santa Clara County’s move to transition its Medi-Cal infrastructure to a “single plan” model, calling the move a “hostile takeover,” the Mercury News reported May 22. Santa Clara Family Health Plan…

Hospitals and medical practices faced slower payment processing from insurers in 2024 compared to 2023 even as prior authorization denial rates fell, according to new revenue cycle data from Kodiak Solutions. The data was derived from more than 2,100 hospitals…

Advertisement

Urbana, Ill.-based Carle Health will shut down its insurance businesses at the end of 2025.  In a statement shared with Becker’s on May 22, Carle Health said Health Alliance and FirstCarolinaCare will exit all lines of business, including Medicare Advantage,…

Aetna Better Health of Illinois paid $20.4 million in value-based incentive payments to 16 community health centers.  The funding is intended to improve quality of care in underserved communities, according to a May 20 news release.  Three things to know: …

Evernorth, the Cigna Group’s health services arm, will cap out-of-pocket costs for Zepbound and Wegovy, two GLP-1 drugs, at $200.  Members can save up to $3,600 a year compared to purchasing the drugs directly or through consumer programs, according to…

Arkansas Blue Cross & Blue Shield reported a $226.2 million net loss in 2024 and a 15% increase in claims exceeding $1 million.  President and CEO Curtis Barnett told Arkansas Business in May that members under 40 are generating seven-figure…

Advertisement