Payer: Page 4
-
Courtesy of Humana
Humana plots CenterWell expansion in 2024
The payer is leveraging CenterWell’s growing network of primary care centers for seniors to boost margins in its hard-pressed Medicare Advantage business.
By Rebecca Pifer • Jan. 31, 2024 -
Julia Rendleman via Getty Images
Cigna sells Medicare businesses to HCSC for $3.7B
The transaction exits Cigna from a sector that’s been a huge source of growth for insurers but has seen its earnings potential shrink.
By Rebecca Pifer • Jan. 31, 2024 -
Explore the Trendline➔
RossHelen via Getty Images
TrendlineSocial determinants of health
The focus on social determinants of health has only increased because of the impacts of the pandemic, with payers and providers trying to new ways to address the issues.
By Healthcare Dive staff -
dventtr via Getty Images
Medicare Advantage profitability is declining, Moody’s says
Insurers' MA earnings were 2% lower in 2022 than in 2019, signaling profits in the lucrative insurance program may be weakening.
By Emily Olsen • Jan. 30, 2024 -
Spencer Platt via Getty Images
Medicare ACO participation grows in 2024: CMS
However, growth in Medicare's flagship shared savings model has plateaued over the past five years, according to government data.
By Rebecca Pifer • Jan. 30, 2024 -
erdikocak via Getty Images
No Surprises Act prevented 10M surprise bills in first nine months of 2023, insurer groups say
AHIP and BCBSA also took aim at providers for allegedly abusing the billing dispute resolution process set up by No Surprises, in the latest salvo over the polarizing law.
By Rebecca Pifer • Jan. 29, 2024 -
JaysonPhotography via Getty Images
Humana names inaugural ‘Growth President’ after posting grim financial outlook
David Dintenfass will have his hands full trying to right the ship, as Humana stares down expectations for notably slower growth in 2024 and beyond.
By Rebecca Pifer • Jan. 26, 2024 -
Stock Photo via Getty Images
Appeals court rejects doctors’ challenge to No Surprises Act
A three-judge panel of the Second Circuit Appeals Court has dismissed claims from a New York medical group that the law amounts to an unconstitutional seizure of their property.
By Rebecca Pifer • Jan. 25, 2024 -
rabbit75_ist/iStock/Getty Images Plus via Getty Images
Humana posts big loss, dour outlook on Medicare Advantage cost spike
The health insurer’s stock plunged Thursday morning following its 2023 results, which fell startlingly short of Wall Street’s expectations.
By Rebecca Pifer • Jan. 24, 2024 -
Permission granted by Elevance Health
Elevance controls medical costs to $6B profit in 2023
The payer curbed the worst of medical cost growth last year, and expects to do the same in 2024 — an assumption one analyst called “aggressive” given persistent higher utilization among seniors.
By Rebecca Pifer • Jan. 24, 2024 -
Nathan Howard via Getty Images
Senator probes MA exchanges’ marketing tactics
The head of the Senate Finance Committee sent letters to several health insurance exchanges on Tuesday, as part of an inquiry into allegedly predatory Medicare Advantage marketing to seniors.
By Sydney Halleman • Jan. 24, 2024 -
Samantha Liss/Healthcare Dive
Centene names Wellcare CEO
Michael Carson, a veteran of the insurance and value-based care industry, has been tapped to lead Centene’s Medicare business.
By Rebecca Pifer • Jan. 22, 2024 -
Dean Drobot/Shutterstock
Sponsored by TeleperformanceImplementing high-tech, high-touch digital services to create more personalized, patient-centric care
Improve the patient experience by addressing high interaction volume and channel complexity.
By Jeff Hechemy, Executive Vice President – Healthcare at Teleperformance • Jan. 22, 2024 -
Staff via Getty Images
Sponsored by PegasystemsAdaptive AI: Driving value beyond the hype
Generative AI gets the attention, but adaptive AI drives the value.
By Robert Connely, Global Market Leader for Healthcare, Pegasystems • Jan. 22, 2024 -
Samantha Liss/Healthcare Dive
Centene wins New Hampshire Medicaid contract
It’s not yet clear how much the new Medicaid managed care contract is worth. The state’s previous contract with insurers, including Centene, allocated $6 billion in funds over five years.
By Rebecca Pifer • Jan. 19, 2024 -
Gerenme via Getty Images
Bright Health rebrands as NeueHealth, distances itself from insurance portfolio
After exiting the insurance business, the tech company will focus on providing care support and solutions for consumers and providers.
By Susanna Vogel • Jan. 18, 2024 -
rabbit75_ist/iStock/Getty Images Plus via Getty Images
Humana slashes 2023 profit outlook as high medical costs continue
The insurer also lowered its expectations for Medicare Advantage membership growth this year to below the industry average.
By Rebecca Pifer • Jan. 18, 2024 -
ipopba via Getty Images
Top healthcare trends in 2024
Here’s what industry experts see coming down the pike for hospitals, insurers and digital health companies this year.
By Healthcare Dive Staff • Jan. 18, 2024 -
Scott Eisen via Getty Images
Cigna CFO takes on expanded role as head of benefits division
Brian Evanko will serve as president and CEO of the Cigna Healthcare insurance division in addition to his position as chief financial officer.
By Emily Olsen • Jan. 17, 2024 -
Gerenme via Getty Images
Rising health insurance premiums linked to wage stagnation, study finds
Families with employer-sponsored plans missed out on an average of more than $125,000 in earnings over more than three decades as premiums increased, according to a study published in JAMA Network Open.
By Emily Olsen • Jan. 17, 2024 -
Alex Wong / Staff via Getty Images
CMS finalizes rule tightening prior authorization turnaround for insurers
Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones — that should cut back coverage determination limbo for patients.
By Rebecca Pifer • Jan. 17, 2024 -
dventtr via Getty Images
MA spending to outstrip traditional Medicare by $88B this year: MedPAC
MedPAC released the data Friday during a contentious meeting where members argued over the efficacy of Medicare Advantage.
By Rebecca Pifer • Jan. 16, 2024 -
iStock / Getty Images Plus via Getty Images
Deep DiveTrends shaping the business of health insurance in 2024
The uninsured rate will rise. Medicare Advantage enrollment will swell, with less instability. Major pharmacy benefit managers will launch more transparent products. Here’s what industry watchers are expecting in 2024.
By Rebecca Pifer • Jan. 16, 2024 -
Courtesy of UnitedHealth Group
UnitedHealth reports highest medical costs since COVID-19 pandemic’s start
While the insurer continues to be rocked by more seniors seeking outpatient care, the fourth quarter also saw high levels of vaccinations and COVID-19 admissions that accelerated spending.
By Rebecca Pifer • Jan. 12, 2024 -
Adeline Kon/Healthcare Dive/Healthcare Dive
ACA enrollment for 2024 reaches record high
More than 20 million Americans have signed up for Affordable Care Act plans since open enrollment began in November. Sign-ups are expected to continue to grow.
By Rebecca Pifer • Jan. 11, 2024 -
dventtr via Getty Images
Kentucky-based Baptist Health drops UnitedHealthcare, Centene MA plans
Kentucky-based Baptist Health has gone out of network with UnitedHealthcare and Centene’s WellCare Medicare Advantage plans after failing to agree to contract terms.
By Sydney Halleman • Jan. 10, 2024
Previous
