Today's Top 20 Stories

  1. 10 providers seeking payer contracting talent

    Andrew Cass -
    Ten providers recently posted job listings seeking leaders in payer contracting and relations.

  2. Meet UnitedHealth's executive team

    Andrew Cass -
    UnitedHealth Group has made several executive leadership moves in 2024, including adding president to CFO John Rex's title and naming Heather Cianfrocco Optum's CEO. 

  3. Investigation reveals UnitedHealth, Cigna, Aetna made millions in fees from out-of-network claims

    Rylee Wilson -
    Major insurers made millions in fees by using MultiPlan, a data analytics firm, to determine how much to pay providers for out-of-network claims, according to an investigation from The New York Times. 

The state of AI in healthcare

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  1. 7 prior authorization updates

    Andrew Cass -
    From Point32Health announcing home health prior authorization cuts to a state's proposed gold carding program legislation failing, here are seven updates on prior authorization that Becker's has reported since March 21.   

  2. Clover Health faces delisting threat for 2nd time

    Andrew Cass -
    For the second time in just shy of a year, Clover Health is facing a possible Nasdaq delisting. 

  3. CVS Health's 5 highest-paid executives in 2023

    Andrew Cass -
    CVS CEO Karen Lynch was paid $21.6 million in total compensation in 2023, according to a regulatory filing published April 5.  

  4. Payer outlook clouded by rising Medicare utilization: Fitch

    Andrew Cass -
    A Medicare utilization surge in the fourth quarter of 2024 is clouding the health insurance industry's outlook in 2024, according to an April 8 report from Fitch Ratings shared with Becker's. 

How one Midwest hospital is driving financial efficiency with interconnected systems

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  1. 5 payer M&A updates

    Andrew Cass -
    From UnitedHealth Group's plans to buy a physician group from Steward Health Care to Elevance buying Kroger's speciality pharmacy business, here are five payer merger and acquisition updates that Becker's reported since March 15: 

  2. 3 things to know about UnitedHealthcare's new Medicare president

    Andrew Cass -
    UnitedHealthcare recently named Robert Hunter president of its Medicare business.

  3. BCBS Massachusetts boosting reimbursement rates to small primary care practices

    Andrew Cass -
    Blue Cross Blue Shield of Massachusetts is increasing reimbursement rates to qualifying small, independent primary care practices. 

  4. Aetna, Dignity cut ties across California, Arizona, Nevada

    Jakob Emerson -
    Aetna's commercial and Medicare Advantage plans went out of network with Dignity Health facilities in California, Arizona and Nevada on April 4.

How one Midwest hospital is driving financial efficiency with interconnected systems

Sponsored
Major time savers can stem from single logins. That's how 1 hospital achieved a 50% reduction in month-end close time — read the short case study, here.

  1. 5 payers among Newsweek's most trustworthy companies in 2024

    Rylee Wilson -
    Aetna and UnitedHealth Group earned spots on Newsweek's list of the most trustworthy companies in 2024. 

  2. Oscar Health's ACA bet starts to pay off

    Rylee Wilson -
    Of the 24 start-up companies selling insurance when the ACA market first opened, Oscar Health is the last one standing. 

  3. CMS finalizes 2025 Medicare Advantage rule: 11 key updates

    Jakob Emerson -
    CMS issued its final 2025 Medicare Advantage and Part D rule April 4, setting new standards around marketing, broker payments, and prior authorization.

  4. Why one payer CEO feels good about CMS' Medicare Advantage rates

    Rylee Wilson -
    Clover Health CEO Andrew Toy feels good about CMS' 2025 Medicare Advantage rates. 

  5. CareFirst BCBS offers support in wake of Baltimore bridge collapse

    Rylee Wilson -
    CareFirst BlueCross BlueShield is offering space in its Baltimore headquarters for Small Business Administration employees assisting business owners in the wake of the Francis Scott Key Bridge collapse. 

  6. 7 recent UnitedHealth leadership moves 

    Jakob Emerson -
    From CEO to COO, these are seven moves from top executives that have taken place this year across UnitedHealth Group's core lines of business:

  7. Healthcare services ranked by Medicare Advantage utilization increases

    Jakob Emerson -
    Medicare Advantage plans saw utilization rates rise 8.1% in the fourth quarter of 2023, primarily driven by outpatient and emergency room services, according to an AHIP survey.

  8. UnitedHealthcare names Medicare president

    Jakob Emerson -
    UnitedHealthcare has named Robert (Bobby) Hunter as president of its Medicare business.

  9. Aetna, Horizon BCBS snag New Jersey state employee benefits contracts

    Jakob Emerson -
    Nearly 600,000 New Jersey state and public school employees, along with their dependents, now have the choice to enroll in health plans offered by Aetna and Horizon Blue Cross Blue Shield of New Jersey.

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