Payer

UnitedHealth Group executives are telling investors that the pressure on Medicaid margins from redeterminations is likely to be short-lived. 

UnitedHealth Group posted $4.2 billion in net income during the second quarter of 2024, a 23% decline year over year.

From new star ratings to market departures, these are seven recent Blue Cross Blue Shield updates involving Medicare Advantage:

Elevance Health struck a deal with Astrana Health to operate clinics for Anthem Blue Cross members in California. 

Current and former Centene board members, along with former senior executives, have beat a pension fund derivative lawsuit alleging the company overbilled state Medicaid programs for pharmacy services.

A trial is underway to determine if Florida failed to properly notify Medicaid beneficiaries it disenrolled during the unwinding process, the Miami Herald reported July 11.  

Aetna failed to accurately calculate qualified payment amounts for air ambulance services, CMS' first audit of an insurer's No Surprises Act compliance found. 

Investing in digital and artificial intelligence technologies is a higher priority for payer CFOs than for their health system counterparts, according to a July 10 report from Deloitte.

CMS published updated star ratings for dozens of Medicare Advantage plans, and a federal judge paused a new CMS regulation that would cap the amount insurers can pay brokers who sell their plans. 

Blue Cross and Blue Shield of Louisiana has moved its care management processes and several provider services to the Epic Payer Platform.