Today's Top 20 Stories
Florida Blue-Aledade ACO reports $14M in savings, improved patient outcomes
Aledade, a network of independent primary care providers, and Florida Blue's ACO has resulted in millions in shared savings for participating providers and improved health outcomes for 41,000 members in the program's first two years.Highmark's value-based primary care program tops $3B in savings
Highmark's value-based reimbursement program for primary care physicians, True Performance, has saved more than $3 billion in avoided cost savings in Pennsylvania, Delaware and West Virginia since its launch in 2017.Medicare Advantage enrollment on the rise in rural areas
Medicare Advantage enrollment is growing faster in rural and micropolitan areas than in metropolitan areas, according to an analysis from KFF published Sept. 7.
Self-funded plans have little leverage to negotiate with providers: Study
Employers that self-fund their employees' insurance pay moderately more for several medical services than fully funded plans, a study published in the September issue of Health Affairs found.Humana in the headlines: 9 recent updates
Humana filed a challenge to CMS' Medicare Advantage clawback rule and said it plans to expand into in-home primary care.ACA exchange enrollment reaches record high of 15.7 million
ACA exchange enrollment reached a record high in early 2023, and the individual market reached an almost record size, according to an analysis from KFF published Sept. 7.More people are switching from traditional Medicare to Medicare Advantage, HHS finds
Most growth in Medicare Advantage enrollment since 2006 was driven by people switching from fee-for-service Medicare to the program, a study by HHS researchers published in the September issue of Health Affairs found.
BCBS Michigan to cut 20% of prior authorization requirements
Blue Cross Blue Shield of Michigan is the latest payer to announce it is scaling back its prior authorization requirements.Meet Oscar Health's leadership team
Oscar Health has named two more Aetna veterans to its executive leadership, joining former Aetna CEO Mark Bertolini, who joined the company earlier this year.5 recent payer lawsuits, settlements
从在新的医疗Advantag胡玛纳起诉美国卫生和公众服务部e clawback rule, to Prisma Health accusing UnitedHealthcare of breaching a confidentiality agreement, here are five lawsuits and settlements involving payers Becker's has reported since Aug. 16.Alignment Health taps chief medical officer
Alignment Healthcare has named Hyong (Ken) Kim, MD, as its chief medical officer, effective Sept. 25.
12个顶级高管最近离开。为联合健康集团
In 2023, 12 top executives previously with UnitedHealth Group's Optum have announced retirement or new positions with companies across the country.Fewer large employers opting for self-funded insurance
The number of large employers choosing self-pay over fully-insured benefits has declined since 2010, according to a brief from the Employee Benefits Research Institute published Aug. 24.Here's where Medicare Advantage and traditional Medicare differ the most on spending
Medicare Advantage plans generally spend less per enrollee than traditional Medicare plans, but these differences vary widely by condition, a study published in the September issue of Health Affairs found.The mystery behind Medicare's slowed spending
Medicare spending per beneficiary has remained stagnant over the past decade, but the reasons why are unclear, The New York Times reported Sept. 4.Bon Secours sues Anthem BCBS for $93M, alleging unpaid claims
Cincinnati-based Bon Secours Mercy Health is suing Anthem Blue Cross Blue Shield of Virginia for $93 million, alleging the payer owes the health system millions in unpaid claims, according to a lawsuit filed in a Virginia circuit court.BCBS North Carolina names Medicaid CEO
Blue Cross and Blue Shield of North Carolina has named Angela Boykin as CEO of Healthy Blue, the company's Medicaid plan, effective Sept. 1.10 providers seeking payer contracting talent
Ten providers recently posted job listings seeking leaders in payer contracting and relations.Medicare Advantage beneficiaries receive less ongoing at-home care: Study
Medicare Advantage beneficiaries were less likely to receive ongoing at-home care than their counterparts in traditional Medicare but more likely to receive one-time visits, a study published in the September issue of Health Affairs found.Oscar snags 2 more Aetna execs
奥斯卡健康任命了两位前安泰领导人its executive team.
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