Payer

Claims adjudication is a complex process with rising costs. Solutions involve a combination of automation, selective outsourcing and process optimization to lower costs and improve efficiency.

Iowa and Nebraska have the highest percentage of original Medicare enrollees with supplemental benefits, while Hawaii has the lowest, according to an AHIP report published in May.

UnitedHealth Group is running around 500 use-case applications for AI across the organization, CEO Andrew Witty told investors. 

Redeterminations could be shaking up margins in the Medicaid business, payer executives warn. 

Members' satisfaction with their commercial health plans has improved since last year, but the divide between the highest and lowest performing plans is getting bigger, according to J.D. Power's annual Commercial Member Health Plan Study published May 29. 

Overall satisfaction with commercial health plans is up from 2023, but the gap between top-performing and low-performing plans is widening, according to the J.D. Power annual Commercial Member Health Plan Study published May 29. 

From its Optum arm acquiring 10 Minnesota behavioral health clinics to shuffling its top legal lineup, here are 15 updates on UnitedHealth Group Becker's has reported since May 14: 

As some major Medicare Advantage insurers look to shrink enrollments and exit markets, others say reimbursement cuts from CMS are a chance to refocus strategies and provide a better product to their members.

From two new CEOs to year-end financial earnings, these are 10 key updates about Blue Cross Blue Shield companies recently reported by Becker's:

In 2024, 36 states offered Medicare Advantage plans to retired employees, according to a report from KFF published May 23.