Today's Top 20 Stories
  1. 医疗保险优势利润可能受到总统sure in 2024, analysts say

    Medicare Advantage profits will likely be stable in 2023 but could face pressure from rising utilization rates in 2024, according to commentary from AM Best published June 30.
  2. Medicare Advantage in the headlines: 7 recent updates

    New regulations for inpatient services in Medicare Advantage are looming, and new research has found MA enrollees with chronic conditions are likely to stay enrolled in the programand spend less time in the hospital than their fee-for-service counterparts.
  3. States with the largest employee health plans

    State employee health plans are often the largest commercial purchaser of healthcare in each state, according to a report from the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.

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  1. CMS updates Medicare drug price negotiation guidelines

    CMS published updated guidance for the Medicare Drug Price Negotiation program, based on feedback from more than 7,500 public comments.
  2. Medicare Advantage enrollees less likely to receive risky medications: Study

    Medicare Advantage members are less likely to be prescribed high-risk medications than their counterparts in fee-for-service Medicare, a study published June 27 in JAMA Health Forum found.
  3. Retiring Centene exec appointed to Homeward board

    Longtime Centene executive Brent Layton is joining the board of directors for healthcare startup Homeward.
  4. Independence Blue Cross names three new vice presidents

    Independence Blue Cross has promoted Daniel Brown to vice president of provider reimbursement analysis and administration, Michael Hébert to vice president of provider contracting, and Obadiah Sang to vice president of corporate development and strategic investments.

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  1. Molina to acquire Bright Health's Medicare Advantage business in $600M deal

    Molina Healthcare will purchase Bright Health Group's California Medicare Advantage business for $600 million, the two businesses said June 30.
  2. Health insurance executive moves | 2023

    Payer executive moves reported by Becker's in 2023:
  3. Percentage of Medicaid recipients disenrolled for procedural reasons in 22 states

    A minimum of 80 percent of Medicaid beneficiaries disenrolled from the program were booted for procedural reasons in nine states, according to a June 29 report from KFF.
  4. BCBS Arizona launches primary care subsidiary

    Blue Cross Blue Shield of Arizona has launched a new primary care company, Prosano Health Solutions.

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  1. What makes the health plans top-rated by their members unique? 8 executives explain

    Satisfaction with commercial health plans is on the decline, especially among younger generations, according to J.D. Power's 2023 Commercial Member Health Plan study.
  2. Georgia's Medicaid work requirement program starts July 1: 5 things to know

    Georgia's Medicaid work requirement program is set to begin July 1. Here are five things to know about the program:
  3. BCBS Association sues Texas company over blue cross logo

    The Blue Cross and Blue Shield Association is suing a specialty care management company in Texas for using a logo it says infringes upon and dilutes the BCBS brand.
  4. Why Oscar Health published its AI prototypes

    Oscar Health published a glimpse into how the payer uses AI.
  5. Why state employee health plans struggle to contain costs: 5 things to know

    Health plans for state employees are often the largest commercial healthcare purchasers in their state, but these bargaining powers are not translating to lower costs, according to a report from the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.
  6. UnitedHealthcare cuts out-of-pocket costs for virtual visits under some commercial plans

    UnitedHealthcare is eliminating out-of-pocket costs for its "24/7 Virtual Visits" program for eligible members enrolled in fully insured employer-sponsored plans, starting July 1.
  7. Government watchdog wants CMS to up auditing of Medicaid managed care

    The Government Accountability Office is urging CMS to consider adding Medicaid managed care programs to the scope of its recovery audit program.
  8. 5 ways Medicare Advantage, fee-for-service differ on care for chronic conditions: Report

    Medicare Advantage beneficiaries with three common chronic conditions spend less time in the hospital than their counterparts in fee-for-service Medicare, an industry-backed report found.
  9. 更多的州外壳d follow Michigan in pausing Medicaid disenrollments

    Michigan said it would pause Medicaid disenrollments through July, and more states could follow, The Washington Post reported June 29.

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