Payer

From Kraft Heinz suing Aetna for alleged mismanagement of employee claims data to Elevance Health being sued by contracted labor unions for reportedly restricting claims data access, certain third-party health plan administrators are being forced to answer the big questions…

CMS is conducting a review of Texas' Medicaid enrollment backlogs. 

A generic medication from CivicaScript saved Highmark members $90 per month on average and generated $3 million in savings for the plan, members and group customers, the insurer said in a May 29 news release. 

Public health and the rest of the healthcare delivery system have long operated in silos in the U.S. While progress was made during the COVID-19 pandemic, CDC Director Mandy Cohen, MD, stressed that now is the time to build on…

Blue Cross Blue Shield of Michigan will no longer cover GLP-1 drugs to treat obesity beginning in January, Bloomberg reported June 12. 

A group of U.S. lawmakers have introduced legislation aimed at reforming the Medicare Advantage prior authorization process. 

Value-based strategy helped Humana improve outcomes and reduce costs for patients with chronic kidney disease and end-stage renal disease. 

Weight loss drugs are the number one thing on payers' and employers' minds right now, according to the president of Cigna's pharmacy benefit manager.

Serious complications from birth often emerge weeks postpartum, according to a report published by the Blue Cross Blue Shield Association on June 11. 

"Misplaced nostalgia" for traditional Medicare will not solve the program's problems, SCAN Health Group CEO Sachin Jain, MD, wrote in Forbes on June 10.