Today's Top 20 Stories
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10 providers seeking payer contracting talent
Ten providers recently posted job listings seeking leaders in payer contracting and relations. -
Medicare Advantage rates 'baffling,' lawmakers say
A group of Republican lawmakers are asking CMS to reconsider its proposed 2025 rates for Medicare Advantage. -
3 ways Medicare Advantage affects primary care physicians
There are few statistically significant differences between the way primary care physicians treat patients in Medicare Advantage and fee-for-service Medicare, according to the Commonwealth Fund.
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10 recent payer partnerships
From chronic disease management to mental health investments, these are 10 partnerships announced by health insurers within the last year: -
Georgia Medicaid work requirement program spending more on consultants than care: Report
Georgia's alternative to expanding Medicaid under the ACA has cost $26.6 million through Dec. 31, with 90% of that money going toward administrative and consulting costs, KFF Health News reported March 20. -
10 greatest payers for job starters: Newsweek
Ten health insurers were named to Newsweek's list of "America's Greatest Workplaces for Job Starters 2024." -
States lacking in Medicaid denial oversight, government watchdog says
States and CMS can increase their oversight of denials by Medicaid managed care organizations, according to a report from the Government Accountability Office.
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Centene subsidiary to reimburse hospitals' health equity accreditation costs
Meridian Health Plan of Illinois will reimburse a portion of the certification fees for hospitals that participate in The Joint Commission's Health Care Equity Certification. -
UnitedHealth, Amedisys deal under more scrutiny
Oregon regulators will open a review into UnitedHealth Group's proposed acquisition of Amedisys, after a preliminary report found the deal could hurt competition in the state's markets. -
NewYork-Presbyterian, Aetna reach deal
New York City-based NewYork-Presbyterian has reached a deal with insurer Aetna after weeks of negotiations. -
Elevance Health's specialty care acquisition spree
Elevance Health has picked up several specialty pharmacy and care-based companies in recent years, bolstering the capacity of its health services arm, Carelon.
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Mount Sinai, UnitedHealthcare reach multiyear agreement
UnitedHealthcare and New York City-based Mount Sinai reached a multiyear contract agreement March 19, effective immediately, after a monthslong contract dispute. -
The 10 best health insurance companies of 2024
Kaiser Permanente is the best U.S. health insurance company in 2024, according to Insure.com's annual ranking. -
Highmark Health Plans posts $400M margin for 2023
Highmark Health posted an operating income of $533 million on revenues of $27.1 billion in 2023, bolstered by membership growth in its health plans, the company said. -
Regence BCBS of Utah names medical director
Regence BlueCross BlueShield of Utah has named Mike Woodruff, MD, as executive medical director. -
CMS adds new ACO model: 5 things to know
CMS will introduce a new payment model designed to spur innovation in primary care for Medicare beneficiaries. -
The succession strategy for a 20-year health insurance CEO
UPMC Health Plan CEO Diane Holder has grown the insurer to 4-million plus members and built a strong team capable of a "seamless transition." -
Elevance's CarelonRx to buy Kroger’s specialty pharmacy
Kroger is selling its specialty pharmacy business to CarelonRx, the PBM subsidiary of Elevance Health. -
Change attack update: What 15 payers discussed with the Biden administration
Fifteen insurers and trade groups met with Biden administration officials March 18 to discuss the industry's ongoing response to the cyberattack on Change Healthcare last month. -
Hospitals' Medicare Advantage market share is decreasing — how Geisinger is bucking the trend
Health system-owned Medicare Advantage enrollment continues to grow overall, but providers' share of the national MA market currently sits at 13%, compared to 17% in 2019.
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