Today's Top 20 Payer Articles
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CMS lowers Medicare Advantage premiums: 3 things to know
Average premiums for Medicare Advantage plans will be an average 11 percent lower for the 2021 plan year compared to this year, CMS said Sept. 24. -
Bright Health raises another $500M
Medicare Advantage startup Bright Health raised another $500 million in its latest venture capital funding round. -
Washington hospital may leave Kaiser Permanente's insurance network
Kittitas Valley Healthcare in Ellensburg, Wash., is planning on leaving Kaiser Permanente's insurance network, according to the Daily Record. -
UnitedHealth in talks to buy Illinois pharmacy startup for $300M
UnitedHealth Group is in advanced talks to buy an online Illinois pharmacy startup called DivvyDose for about $300 million, people familiar with the matter told Bloomberg. -
BCBS insurers reach tentative $2.7B deal over antitrust case
Blue Cross Blue Shield insurers tentatively reached a settlement in an antitrust lawsuit that accuses the companies of conspiring to divide markets and avoid directly competing with each other, according to The Wall Street Journal. -
House votes to repeal health insurer antitrust exemption: 4 things to know
On Sept. 21, the U.S. House of Representatives passed a bill that would repeal antitrust exemptions for health insurers. -
Independence Health Group CEO to retire
Daniel Hilferty, president and CEO of Independence Health Group, which runs Independence Blue Cross and AmeriHealth Caritas, is retiring. -
BCBS of Michigan offers buyouts to 8,500+ employees
Blue Cross Blue Shield of Michigan is giving more than 8,500 employees voluntary separation offers to help manage its administrative costs, the insurer said in a statement to Becker's Hospital Review. -
BCBS Association sues investment manager over $2B loss
Blue Cross Blue Shield Association's national employee benefit committee filed a lawsuit against an investment firm after losing $2 billion from its benefit plan trust, according to Pensions & Investments. -
California hospital may end Medicaid agreement with Anthem
Enloe Medical Center in Chico, Calif., may no longer be in network with Anthem Blue Cross' managed Medicaid plan if an agreement on reimbursement rates isn't reached, according to the Enterprise-Record. -
Tennessee insurers send premium rebates to 143,000 members
BlueCross BlueShield of Tennessee and Cigna are issuing rebate checks to Tennessee residents because their healthcare costs were lower than expected, the state's Department of Commerce and Insurance said Sept. 17. -
Vermont's all-payer model isn't meeting targets, needs revamp, CMS says
CMS sent a warning notice to Vermont last week calling for a reboot of its all-payer model, which hasn't met its participation or savings goals, according to the VT Digger. -
9 recent payer-provider contract agreements, disputes
These nine contract resolutions and dissolutions occurred between payers and providers since early September, beginning with the most recent: -
Atlantic Health System, Horizon say tying payments to outcomes lowered costs 5%
Morristown, N.J.-based Atlantic Health System and Horizon Blue Cross Blue Shield of New Jersey said their shared accountability program is working and has lowered costs by 5 percent in its first year. -
How technology is reshaping payer-provider collaboration — 4 points
Effective collaboration between payers and providers can be challenging, particularly as more people receive care outside of the hospital and providers shift to reimbursement based on quality of care, rather than volume. -
When telehealth cost-sharing waivers expire for 5 payers
In light of the COVID-19 pandemic, many commercial health insurers waived cost-sharing for medical and behavioral telehealth services. -
EmblemHealth unit overstated Medicare supplemental costs, OIG says
Group Health Inc., a subsidiary of EmblemHealth, overstated its supplemental executive retirement plan costs to Medicare, according to a report from HHS' Office of Inspector General. -
4 new hospital-insurer partnerships
Here are four new partnerships that hospitals and health insurers recently announced: -
Uninsured rates by state: 2010 vs. 2019
In 2019, 9.2 percent of Americans, or 29.6 million, didn't have health insurance. That's down from 15.5 percent in 2010, before many provisions of the ACA took effect. -
Census Bureau: More Americans may be forgoing health insurance
A million more people likely went without health insurance in 2019 than the year before, according to a new report from the Census Bureau.