Payer: Page 2


  • Image attribution tooltip
    Fotolia

    Molina’s contract wins will have ‘profound impact’ on company, CEO says

    The string of Medicaid contracts amount to $5.8 billion in additional annual premium revenue, according to CEO Joe Zubretsky.

    By Oct. 27, 2022
  • An image of an Express Scripts prescription bottle.
    Image attribution tooltip
    Courtesy of Express Scripts
    Q&A

    Express Scripts lands its largest client in Centene

    Cigna’s Express Scripts will manage more than $35 billion in annual prescription drug spend for Centene, which will soon be its No. 1 client.

    By Oct. 26, 2022
  • Explore the Trendline
    Image attribution tooltip
    Yujin Kim/Healthcare Dive
    Trendline

    Payer/Provider relationships

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

    By Healthcare Dive staff
  • Nearly half of consumers are in debt due to medical bills, survey finds

    Many are struggling to afford their private health insurance and are unprepared for a medical emergency, a poll conducted for telehealth provider Babylon showed.

    By Oct. 26, 2022
  • Mental health clinicians on strike
    Image attribution tooltip
    Retrieved from National Union of Healthcare Workers on October 25, 2022

    10-week Kaiser strike ends with deal aimed at improving mental health access

    About 2,000 mental health clinicians at the system’s facilities in Northern California walked off the job in protest of what they said were prolonged wait times and unmanageable work loads.

    By Oct. 25, 2022
  • Image attribution tooltip
    Express Scripts Holding Co.

    Cigna’s Express Scripts wins Centene’s $35B prescription drug contract

    The PBM contract is one of the largest to change hands recently, one analyst said. Centene will drop CVS Caremark in 2024.

    By Oct. 25, 2022
  • A family and a doctor standing around a hospital bed waiting for results from the doctor
    Image attribution tooltip
    Rido via Getty Images
    Sponsored by Consensus Cloud Solutions

    Leveraging AI to benefit the healthcare ecosystem for providers, payers and members

    Research revealed leveraging AI will benefit the entire healthcare ecosystem for payers.  

    By Bevey Miner, HIT Strategist, Consensus Cloud Solutions • Oct. 24, 2022
  • A calculator and stethoscope rest on a medical bill.
    Image attribution tooltip
    erdikocak via Getty Images

    Elevance says it’s now the largest US insurer, beating out UnitedHealthcare. Analysts say it’s not that simple.

    CEO Gail Boudreaux said the company has solidified its spot as the top insurer, but some analysts aren’t ready to crown the company with that title — yet.

    By Oct. 21, 2022
  • Entryway of Crossover Health's clinic in Phoenix, Arizona
    Image attribution tooltip
    Courtesy of Crossover Health

    Crossover Health in talks with multiple major insurers to offer capitated primary care

    Crossover has been working on extending its business model to payer clients for several years now, and will have more news to share by the end of the year.

    By Oct. 21, 2022
  • A judge's gavel is shown sitting idle on a thick, cherry stained, perhaps mahogany desk. The judge's hands are visible but out of focus in the background.
    Image attribution tooltip
    Kuzma via Getty Images

    Molina whistleblower case moves forward after SCOTUS declines to hear challenge

    A former contractor alleged the payer billed and received payment from the Illinois Medicaid program for services it did not provide.

    By Oct. 19, 2022
  • U.S. economy contracted for second consecutive quarter
    Image attribution tooltip
    Baris-Ozer via Getty Images

    Elevance Health records $1.6B profit as it braces for recession

    CEO Gail Boudreaux attempted to temper concerns about the impact a recession may have on the company during a Q3 earnings call Wednesday.

    By Oct. 19, 2022
  • An illustration of a large dollar coin with medical supplies flying in the foreground is positioned on an analysis tracking chart background.
    Image attribution tooltip

    Illustration: Xavier Lalanne-Tauzia for Industry Dive

    Falling MA star ratings dog payers’ future earnings

    Volatility in MA stars for the 2023 plan year is raising questions around the earnings outlooks issued by payers.

    By Oct. 18, 2022
  • Image attribution tooltip
    Scott Eisen via Getty Images

    DOJ sues Cigna for exaggerating patient illnesses

    The insurer paid vendors to conduct in-home visits with its members, then pressured the vendors to record high-value diagnoses that would lead to higher payments for Cigna, the DOJ alleges.

    By Oct. 18, 2022
  • A patient sits on an examination table in a doctor's office while a physician stands to the side and listens in a stethoscope
    Image attribution tooltip
    Joe Raedle/Getty Images via Getty Images

    HHS approves Medicaid housing intervention program in Arizona

    It’s the latest demonstration approval from the agency, following others in Oregon and Massachusetts targeted at expanding access to coverage and addressing nutrition and housing needs.

    By Oct. 17, 2022
  • A person holds their head in distress
    Image attribution tooltip

    Photo by Liza Summer from Pexels

    States need help to enforce mental health parity laws, report finds

    Researchers from Georgetown University advocate for more federal support to remove insurance-related obstacles to treatment.

    By Oct. 17, 2022
  • Cropped view of patient at table with insurance claim form giving credit card to doctor.
    Image attribution tooltip

    LightFieldStudios via envatoelements

    Sponsored by CSG Forte

    Healthcare payments: Remedy these 3 compliance risks

    Explore potential consequences and remedies for 3 compliance risks in the healthcare payments space.

    Oct. 17, 2022
  • Image attribution tooltip
    Fotolia
    Opinion

    Price transparency data provides new visibility into real rates paid to providers

    Payers can use the data to gain insights regarding the rates hospitals have negotiated with other payers, which potentially can be used during contract negotiations, BRG analysts argue.

    By JoAnna Younts and Konstantin Gorelik • Oct. 14, 2022
  • UnitedHealth Group's headquarters building in Minnetonka, Minnesota.
    Image attribution tooltip
    UnitedHealth Group

    UnitedHealth raises 2022 earnings outlook following Q3 beat

    Management said they expect Change Healthcare to be accretive to earnings starting in 2023, not in 2022 as previously expected.

    By Oct. 14, 2022
  • A picture of the exterior of the US Department of Health and Human Services. In front of the building is a black sign designating the building's name.
    Image attribution tooltip
    Alex Wong via Getty Images

    Family glitch fix for ACA premium subsidies finalized

    The new rule extends premium subsidies to previously ineligible dependents of workers with employer-sponsored coverage.

    By Oct. 12, 2022
  • Image attribution tooltip
    Getty Images

    Wasteful administrative costs tied to high US health spending

    A Health Affairs research brief identified at least half of nonclinical health expenditures as excessive.

    By Oct. 11, 2022
  • a picture of a red stethoscope on top of a US billed money.
    Image attribution tooltip
    Adeline Kon/Healthcare Dive/Healthcare Dive

    Beleaguered Bright slashes footprint, fully exiting ACA markets and restricting MA to 2 states

    Bright Health is doubling down on its decision earlier this year to contract its business, halting the sale of ACA plans to focus on care delivery business NeueHealth as well as MA in higher-performing markets.

    By Oct. 11, 2022
  • A calculator and stethoscope rest on a medical bill.
    Image attribution tooltip
    erdikocak via Getty Images

    Hospitals are hiding prices from patients, advocacy report says

    Patient Rights Advocate concluded that some hospitals owned by Ascension and HCA Healthcare are omitting rates for medical services from files made public under new federal rules.

    By Oct. 10, 2022
  • Medical professional showing patient information on digital tablet.
    Image attribution tooltip

    iStock/Alina555

    Fewer MA plans with Part D earn 4 stars in latest CMS tally

    Just over half of plans received four stars or more for 2023, a sharp decrease from 68% last year.

    By Oct. 10, 2022
  • An illustration of a hospital and a medical corporate building pieced together like a puzzle.
    Image attribution tooltip

    Illustration: Xavier Lalanne-Tauzia for Industry Dive

    Molina closes $110M AgeWell deal

    The payer will pick up 13,000 members from New York-based AgeWell who are chronically ill or disabled and covered by its long-term care services.

    By Oct. 6, 2022
  • A piggy bank rests near a stethoscope.
    Image attribution tooltip
    marchmeena29 via Getty Images

    Providence to refund some 760 low-income patients wrongly charged for care

    The refunds come after a New York Times investigation found Providence pressured qualified Medicaid patients to pay for care, even though they were entitled to free services.

    By Oct. 6, 2022
  • A sign advertises Cigna's free health screenings as the Cigna HIT tour takes to the beach on May 31, 2019 in Virginia Beach, Virginia.
    Image attribution tooltip
    Julia Rendleman via Getty Images

    Cigna expands MA presence by 22% for 2023

    Despite previously lagging in the market, Cigna is now among the fastest-expanding MA providers, analysts said.

    By Oct. 5, 2022