During fiscal year 2025, Medicaid enrollment dipped while spending grew, according to a Nov. 13 KFF brief. The nonprofit organization hired Health Management Associates to consult state Medicaid directors across the country on recent trends. Florida, Kansas and Mississippi did…
Payer
Major payers reported mixed third-quarter results amid rising medical costs and operational headwinds, a stark contrast to the more robust performance seen by some of the largest for-profit health systems. Becker’s compared Q3 performance across six major payers — UnitedHealth…
Indiana is removing MDwise as a managed care health plan offered within the state’s Medicaid programs, effective Jan. 1. MDwise is part of Grand Blanc, Mich.-based McLaren Health Care. Its current Medicaid contract with Indiana was awarded in 2023, and…
Elevance Health’s Medicaid business is expected to reach a low point on profits in 2026, according to the company’s CFO, Mark Kaye. While speaking at the UBS Global Healthcare Conference on Nov. 11, Mr Kaye said the company anticipates its…
From lawmakers seeking to halt an upcoming Medicare pilot to BCBS of Alabama and physicians outlining shared commitments, here are six updates on prior authorization that Becker’s has reported since Oct. 8: 1. Six Democratic House representatives introduced legislation to…
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President Donald Trump proposed that federal healthcare funds bypass insurers and be directed straight to individuals in a Nov. 8 post on Truth Social. “I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent…
From the company’s CFO outlining financial turnaround plans to Optum launching an AI-powered claims system, here are 10 updates on UnitedHealth Group and its subsidiaries that Becker’s has reported since Oct. 21: 1. UnitedHealth Group CFO Wayne DeVeydt laid out…
UnitedHealth Group CFO Wayne DeVeydt laid out a roadmap to improve the company’s financial performance during an interview at the UBS Global Healthcare Conference on Nov. 10. “Having competed against this organization for years, both as the CFO of Elevance…
Over the next several months, health plans, health systems, policymakers and patients led by Baltimore-based Johns Hopkins will begin addressing prior authorization as part of a convening group. While the group is meeting for the first time today, it will…
UnitedHealthcare will not cover remote physiologic monitoring when it is “unproven and not medically necessary,” including for Type 2 diabetes and most cases of hypertension. However, it will still cover monitoring for heart failure and hypertensive disorders of pregnancy, according…