Payer Issues

UPMC physician to be Humana's new CMO: 5 things to know

Humana named William Shrank, MD, CMO of the insurance services division at UPMC Health Plan, its new CMO, the health insurer said Jan. 15. By Morgan Haefner - 1/15/19

10 recent payer, provider contract disputes, resolutions

These 10 contract resolutions and dissolutions occurred between payers and providers since early December, beginning with the most recent: By Morgan Haefner - 1/15/19

BCBS of Western New York reaches agreement with Catholic Health, 1,000 physicians

BlueCross BlueShield of Western New York reached a three-year agreement with Buffalo, N.Y.-based Catholic Health and its affiliated physicians, Catholic Medical Partners, according to The Buffalo News. By Morgan Haefner - 1/15/19

Anthem inks OTC agreement with CVS

Anthem Medicare Advantage members in California and New York can purchase over-the-counter medications and health supplies at CVS Pharmacy stores using their health plan allowance beginning in January, the companies said Jan. 14. By Morgan Haefner - 1/15/19

Tenet, Humana sign agreement through 2023

Dallas-based Tenet Healthcare signed a multiyear agreement that will allow Humana members to access the system's hospitals, outpatient centers and employed physicians at in-network rates through May 2023, the companies said Jan. 15. By Morgan Haefner - 1/15/19

Georgia health plan offers employees $150 Walmart gift cards for meeting wellness goals

Georgia's health insurance plan is rewarding state employees for hitting health and wellness targets, according to Georgia Health News. By Morgan Haefner - 1/15/19

Physician-led health plan adds 24,000 Medicaid patients in Florida

Lighthouse Health Plan, a physician-led Medicaid health plan in Pensacola, Fla., will begin serving 24,000 patients Feb. 1, according to the Pensacola News Journal. By Morgan Haefner - 1/15/19

UnitedHealth's Optum revenues surpass $100B for 1st time

Growth in UnitedHealth Group's health services business Optum helped the health insurance company beat Wall Street estimates for the fourth quarter ended Dec. 31, according to Reuters. By Morgan Haefner - 1/15/19

BCBS of North Carolina to fund PCP program amid shortage

Blue Cross and Blue Shield of North Carolina will invest $750,000 in a program aimed at addressing the state's primary care physician shortage, the health insurer said Jan. 7. By Morgan Haefner - 1/14/19

CVS commits $100M to community health after Aetna tie-up

CVS Health will spend $100 million during the next five years on community health initiatives, the company said Jan. 14. By Morgan Haefner - 1/14/19

UPMC Cole president clarifies insurance changes for Highmark members: We'll 'continue to be in network'

Coudersport, Pa.-based Cole Memorial Hospital officially completed its integration with Pittsburgh-based UPMC March 1, 2018, and was rebranded UPMC Cole under the agreement. By Morgan Haefner - 1/14/19

4 recent payer executive moves

Four recent health insurer hires and retirements, as reported by Becker's Hospital Review since Jan. 3: By Morgan Haefner - 1/14/19

Anthem in Maine gets new president: 3 things to know

Anthem Blue Cross and Blue Shield in Maine appointed Denise McDonough president of commercial business in the state Jan. 10, according to Mainebiz. By Morgan Haefner - 1/14/19

Humana can't seal documents in antitrust suit involving Louisiana health system

Although not a litigant, Humana can't seal confidential business documents that a judge ordered unsealed but redacted in a larger antitrust lawsuit, according to court documents. By Morgan Haefner - 1/11/19

BCBS of Kansas City CEO to retire: 3 things to know

Danette Wilson, president and CEO of Blue Cross and Blue Shield of Kansas City, is retiring after more than 30 years with the company, the health insurer said Jan. 10. By Morgan Haefner - 1/11/19

Cigna eyes Medicare Advantage expansion: 3 things to know

Cigna sees a major business opportunity in expanding its Medicare Advantage offerings in coming years, according to Forbes contributor Bruce Japsen. By Morgan Haefner - 1/11/19

Medicaid is reducing poverty over time, study finds

While out-of-pocket healthcare spending pushed more than 10.5 million Americans into poverty in 2016, Medicaid helped offset this risk, according to a study published in Health Affairs. By Morgan Haefner - 1/11/19

How UPMC Health Plan is changing its vendor selection process

UPMC Health Plan is expanding its vendor pool to include smaller and more diverse partners, according to the Pittsburgh Post-Gazette. By Morgan Haefner - 1/10/19

BCBS of Vermont names CIO: 3 things to know

Blue Cross and Blue Shield of Vermont appointed Victoria Hildebrand CIO, the health insurer said Jan. 9. By Morgan Haefner - 1/10/19

America's largest health insurers in 2018

Here are the eight health insurers with the most members and revenue in 2018, as reported by Forbes: By Morgan Haefner - 1/10/19

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