Payer

In the highly-competitive insurance industry, payers are constantly tasked with finding new ways to differentiate themselves from their competition. An often-overlooked opportunity to stand out among the crowd is the provider data management and the credentialing process.

Health insurers selling plans on HealthCare.gov denied 17 percent of in-network claims on average during the 2016 plan year, according a Kaiser Family Foundation analysis.

Humana President and CEO Bruce Broussard recently moved to sell $7.5 million worth of stock, according to a Feb. 22 filing with the Securities and Exchange Commission.

Healthcare stock declines are being led by losses in the health insurance sector after Democrats introduced a new "Medicare for All" bill that would replace private health plans with a government option, according to Bloomberg.

Rep. Pramila Jayapal, D-Wash., is the latest Democrat to unveil a bill aimed at instating a "Medicare for All" health insurance system, according to NBC News.

Mark Bertolini, former CEO of Aetna — now owned by CVS Health — compared the U.S. healthcare system to the auto industry in an interview at the Chief Executives for Corporate Purpose's annual "Board of Boards" event, according to Chief…

Limited trust has existed between payers and providers thanks to disagreements over networks, prior authorization and price variation; however, now is the time to change this dynamic, executives from UnitedHealth Group, Anthem and Permanente Medical Group wrote in a JAMA…

Texas lawmakers are proposing bills aimed at overhauling the Texas Medicaid system after a Dallas Morning News investigation uncovered how managed care companies are skimping on treatments and medical equipment.

Health plans are looking for new ways to compete for customers, and some are finding that collaborating with healthcare providers can improve outcomes and costs for members; however, payers still have to persuade wary providers to work with them, according…

Minnesota is the state with the highest percent of enrollment in Medicare Advantage and other plans, according to CMS data.