BCBS Tennessee reports $22M income in 2022
BlueCross BlueShield of Tennessee reported $21.8 million in net income for 2022, down from $521.1 million in 2021.Leqembi could cost Medicare up to $17.8B
Leqembi, the newly-approved drug that can slow the progression of Alzhemier's disease, will cost Medicare billions each year, according to an analysis from KFF.Cigna beats class-action bid alleging it overcharged for medical equipment
A federal judge in Connecticut has denied a class-action bid against Cigna for allegedly overcharging members for medical equipment and violating its fiduciary duties under the Employee Retirement Income Security Act.Judge temporarily blocks Aetna Medicare Advantage plan for NYC retirees
A New York judge has temporarily blocked New York City's plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan.Independence Blue Cross, Sun Life partner on stop-loss insurance
Independence Blue Cross is partnering with financial services firm Sun Life to offer stop loss insurance to its self-funded group customers.UnitedHealth Group in the headlines: 11 updates
From its Optum arm striking a deal to acquire Amedisys, to a warning of rising medical costs, here are 11 updates from UnitedHealth Group that Becker's has reported since June 13:Many Medicare Advantage beneficiaries report financial instability, food insecurity, Humana report finds
Nearly half of Medicare Advantage beneficiaries report having at least one health-related social need, a study published in the July issue of Health Affairs found.Payers ranked by Medicaid managed care market share
Five publicly traded companies have 50 percent of the Medicaid-managed care market, according to a July 6 analysis from KFF.Employers are increasingly suing their health plan for claims data
Lawsuits from large companies and employers are increasingly being filed against third-party health plan administrators in an effort to access complete employee medical claims data.3 reactions to Biden's proposed 'junk' health insurance crackdown
拜登政府发布7月提出的规则y 7 that aimed to crack down on "junk" short-term health insurance plans.HHS: Medicare Part D enrollees will save $400 on average in 2025
Caps on Medicare prescription drug costs will save Part D enrollees a collective $7.4 billion in 2025, according to a report from HHS' Office of the Assistant Secretary for Planning and Evaluation.How Priority Health has reduced emergency room visits during pregnancy by 16%
Over the last two years, Priority Health's maternity management program, "PriorityMOM," has achieved a 16 percent decrease in emergency room visits for pregnant members who may experience complications pre- or post-delivery.Key predictors an individual younger than 65 will choose Medicare Advantage
There are several demographic and socioeconomic differences between individuals who select traditional Medicare coverage versus Medicare Advantage plans before they turn 65 and who have commercial insurance, according to a new study from researchers at Harvard Medical School and software firm Inovalon.53 payer executives on the biggest opportunities in Alzheimer's, dementia care
As the number of Americans with Alzheimer's disease or related dementias continues to grow, a survey of payer executives suggests the industry is moving too slow or not at all toward better managing cognitive decline among members.Medicare Advantage star ratings are failing to improve plan quality: Study
The Medicare Advantage star rating system and its quality bonus payment program is failing to achieve its two main goals of helping beneficiaries select a plan and incentivizing payers to improve plan quality, according to a new report from the Urban Institute.4 reasons why most payers, employers don't cover weight loss drugs
The most common reason health plans and employers do not pay for pricey weight loss drugs is because they consider these medications to be lifestyle drugs, according to a survey from Pharmaceutical Strategies Group.Medicaid in the headlines: 10 recent updates
Georgia is implementing work requirements for Medicaid, and other states could follow.Molina, Elevance Health Medicaid membership grew by over 50% during continuous enrollment
Molina Healthcare had the largest gains in Medicaid enrollment during the COVID-19 pandemic, according to a report from KFF published July 6.'Look-alike' dual eligible plans are misleading Medicare Advantage enrollees, researchers say
"Look-alike" dual eligible Medicare Advantage plans — which primarily enroll people eligible for Medicare and Medicaid but are not regulated as D-SNP plans — grew significantly from 2013 to 2020, a study published in the July issue of Health Affairs found.Many Medicare Advantage beneficiaries have few choices for psychiatrists
Many Medicare Advantage plans have narrow networks for psychiatrists when compared to Medicaid managed care and ACA plans, a study published in the July issue of Health Affairs found.
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