Payer: Page 11

  • Robert F. Kennedy Jr., U.S. President Donald Trump’s nominee for Secretary of Health and Human Services departs after testifying in a confirmation hearing before the Senate Committee on Health, Education, Labor and Pensions at the Dirksen Senate Office Building on January 30, 2025 in Washington, D.C.
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    RFK Jr.'s path to HHS secretary

    RFK Jr. fumbles Medicare basics during second confirmation hearing

    Robert F. Kennedy Jr., nominee for HHS secretary, seemed unfamiliar with the massive insurance program during last week’s hearing, mistakenly saying Medicare Part A mainly paid for primary care or physicians.

    By • Jan. 30, 2025
  • Cigna's logo is seen on a door.
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    Julia Rendleman via Getty Images
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    Cigna pledges changes to pharmacy, medical benefits following ‘messy’ close to 2024

    Fresh off underperforming Wall Street’s expectations in the fourth quarter, Cigna said it would work to lower costs for its customers amid widespread discontent with the healthcare system.

    By • Jan. 30, 2025
  • Explore the Trendline➔
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    Yujin Kim/Healthcare Dive
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    Trendline

    Payer/provider relationships

    As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.

    By Healthcare Dive staff
  • Robert F. Kennedy Jr. speaks while sitting at a desk in a U.S. Senate building.
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    Win McNamee via Getty Images
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    RFK Jr.'s path to HHS secretary

    RFK Jr. appears confused about Medicaid, Medicare during confirmation hearing

    Robert F. Kennedy Jr. incorrectly said that Medicaid was fully funded by the federal government and that Medicare is a fee-for-service program during a hearing in front of the Senate Finance Committee last week.

    By • Jan. 29, 2025
  • The White House in Washington, D.C.
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    Alex Wong via Getty Images
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    White House rescinds memo pausing federal funding following pushback

    The Office of Management and Budget rolled back a memo halting federal funding that caused widespread confusion and alarm. But “this is NOT a rescission of the federal funding freeze,” Trump’s top press secretary said.

    By • Jan. 29, 2025
  • A medical professional rests their hand on a laptop keyboard while a stethoscope sits on the table next to them.
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    Healthcare’s outlook in 2025: New administration spells uncertainty, but hope remains

    Although experts predict payers, providers and health technology companies will grapple with uncertainty in a second Trump administration, some hope that yearslong headwinds could begin reversing course in 2025.

    By • Jan. 29, 2025
  • a closeup of Donald Trump in business attire
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    Justin Sullivan via Getty Images
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    Judge halts Trump freeze on grants as states report healthcare payment portals back online

    States and providers regained access to a key healthcare payments portal amid widespread backlash over the Trump administration’s decision to halt federal aid.

    By • Jan. 29, 2025
  • A stethoscope rests on a pile of $100 bills.
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    Main Line Health threatens to go out of network with Cigna over contract dispute

    Main Line Health says Cigna hasn't updated its reimbursement rate since 2016. Cigna says it is negotiating in good faith to find a solution that keeps healthcare affordable for patients.

    By • Jan. 29, 2025
  • President-elect Donald Trump and Vice President-elect Sen. JD Vance will be sworn in on January 20.
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    Kayla Bartkowski/Getty Images via Getty Images
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    Lawmakers report states shut out of Medicaid payment portals following Trump funding freeze

    Other payment systems also appear to be offline, suggesting a broader shutdown of federal portals related to grants and funding.

    By • Updated Jan. 28, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    UnitedHealth names Tim Noel to replace slain insurance CEO

    UnitedHealthcare has a new chief executive seven weeks after former CEO Brian Thompson was shot and killed in New York City.

    By • Jan. 24, 2025
  • Elevance headquarters is a large white and brown building surrounding a grassy quad.
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    Permission granted by Elevance Health
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    Elevance’s fourth-quarter profit slashed in half amid higher Medicaid costs

    In a call with investors, CEO Gail Boudreaux didn’t directly address the killing of UnitedHealthcare’s top executive but spent more time than usual arguing Elevance is working to improve healthcare.

    By • Jan. 23, 2025
  • a closeup of Donald Trump in business attire
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    Justin Sullivan via Getty Images
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    Americans mixed on potential Trump healthcare priorities: KFF poll

    About half of respondents said the nation should spend more on Medicaid and Medicare — a potential challenge for the Trump administration looking to cut costs.

    By • Jan. 22, 2025
  • Two men stand on the sidewalk outside of an insurance agency.
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    Joe Raedle via Getty Images
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    ACA enrollment breaks records again in 2025

    About 24.2 million people signed up for Affordable Care Act plans during the open enrollment period for 2025, with huge increases in major Republican-led states.

    By • Jan. 21, 2025
  • A piece of paper with the word "Medicare" emblazoned on a blue background
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    Ozempic among drugs picked by Medicare for price talks

    Announcing the 15 medicines chosen for the second round of negotiations is one of the Biden administration’s final health policy acts.

    By Ned Pagliarulo • Updated Jan. 17, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    UnitedHealth reaches record revenue in 2024, though profit falls

    UnitedHealth’s net income plummeted to its lowest level since 2019 amid hefty costs, including some from the Change cyberattack. CEO Andrew Witty also remembered slain executive Brian Thompson on a Thursday morning call.

    By • Jan. 16, 2025
  • A piece of paper with the word "Medicare" emblazoned on a blue background
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    Getty Images
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    Alignment Healthcare names new president as insurer eyes growth

    Medicare Advantage payer Alignment has named longtime insurance executive Dawn Maroney president.

    By • Jan. 15, 2025
  • A sign reading OBAMACARE hangs outside a storefront.
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    Joe Raedle via Getty Images
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    CMS expands enforcement power over shady ACA brokers

    A rule finalized Monday makes it easier for regulators to suspend agents and brokers from selling Affordable Care Act plans if they pose a risk to the exchanges.

    By • Jan. 14, 2025
  • Ferguson and Holyoak join FTC
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    FTC releases second report slamming pharmacy benefit managers

    Agency commissioners voted unanimously on Tuesday to publish the report, which makes similar allegations against the controversial drug middlemen as the agency’s first report released last summer — but relies on more data.

    By • Updated Jan. 15, 2025
  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    Investors ask UnitedHealth for answers about delayed, denied care

    A faith-based group of investors has requested UnitedHealth prepare a report looking into how its practices could be leading to “delay or abandonment of medical treatment and serious adverse events for patients.”

    By • Jan. 13, 2025
  • The HHS in DC
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    CMS proposes Medicare Advantage payment hike in 2026

    The Biden administration’s last MA rule is a boon for insurers, though it remains to be seen how the incoming Trump administration might put its stamp on the regulation before it’s finalized this spring.

    By • Jan. 13, 2025
  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
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    Samantha Liss/Healthcare Dive
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    Centene appoints first head of ICHRA products

    Longtime WTW executive Alan Silver was named the inaugural president of Ambetter Health Solutions. Silver’s mandate is to accelerate growth in Centene’s ICHRA plans.

    By • Jan. 9, 2025
  • The facade of Blue Shield of California's headquarters.
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    Eric Risberg/AP

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    Blue Shield of California restructures, launches health services business and names first female CEO

    The bevy of changes for the massive California nonprofit is meant to improve operations, and should also give Blue Shield a financial leg-up as it competes with well-funded for-profit peers.

    By • Jan. 9, 2025
  • Two men stand on the sidewalk outside of an insurance agency.
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    Joe Raedle via Getty Images
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    ACA signups set to smash record at 24M with enrollment continuing

    The Biden administration attributed the growth to generous subsidies that are scheduled to expire at the end of this year.

    By • Jan. 8, 2025
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    Transcarent to acquire fellow health benefits navigator Accolade for $621M

    If closed, the deal will take Accolade private and create a single firm with more than 1,400 employer and payer clients.

    By • Jan. 8, 2025
  • Shot of CVS Pharmacy logo
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    Mario Tama via Getty Images
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    CVS successfully converts commercial pharmacy contracts to “cost plus” model

    CVS’ efforts to reform how its pharmacies are paid have reached a significant milestone that should stabilize flagging margins.

    By • Jan. 8, 2025
  • A stethoscope rests on a medical insurance claim form.
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    Deep Dive

    Health insurers will step off the roller coaster in 2025

    After a turbulent year, things should calm for payers with the advent of a business-friendly Trump administration — though challenges will persist. Here are experts’ biggest predictions for 2025.

    By • Jan. 8, 2025