Payer: Page

  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
    Image attribution tooltip
    Samantha Liss/Healthcare Dive
    Image attribution tooltip

    Centene echoes Humana’s concerns about proposed MA rate drop

    On the insurer’s earnings call, analysts peppered Centene with questions about its Medicare Advantage business until its CFO attempted to change the subject.

    By • Feb. 6, 2024
  • A teenager sits in front of a computer and a phone on a desk.
    Image attribution tooltip
    Leonardo Fernandez Viloria/Getty Images via Getty Images
    Image attribution tooltip
    Q&A

    BeMe’s CEO Nicki Tessler on digital behavioral health programs and payer partnerships

    Depression and anxiety climbed among teens during the COVID-19 pandemic. Nicki Tessler, CEO and cofounder of BeMe Health, breaks down solutions.

    By Brian T. Horowitz • Feb. 5, 2024
  • Explore the Trendline➔
    Image attribution tooltip
    Yujin Kim/Healthcare Dive
    Image attribution tooltip
    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
  • The HHS in DC
    Image attribution tooltip
    Alex Wong via Getty Images
    Image attribution tooltip

    Humana flags potential MA funding dip if proposed rate notice finalized

    Despite the uncertainty, the insurer reaffirmed its earnings outlook for 2025.

    By • Feb. 5, 2024
  • 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
    Image attribution tooltip

    Cigna is still interested in Medicare

    The health insurer sees Medicare Advantage as an area for future growth, despite selling the division for $3.7 billion. Cigna’s CEO called the sale a “win-win” on a call with investors Friday.

    By • Feb. 2, 2024
  • Two people are seen inside a Medicare Services office.
    Image attribution tooltip
    Spencer Platt via Getty Images
    Image attribution tooltip

    Medicare Advantage plans could see rates dip slightly in 2025

    The CMS proposed a 0.2% dip in MA rates. However, analysts said regulators will likely improve the payment rate in the final notice.

    By • Feb. 1, 2024
  • The blue and green Centerwell Senior Primary Care logo is seen on a clinic's facade.
    Image attribution tooltip
    Courtesy of Humana
    Image attribution tooltip

    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 • Jan. 31, 2024
  • Cigna's logo is seen on a door.
    Image attribution tooltip
    Julia Rendleman via Getty Images
    Image attribution tooltip

    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 • Jan. 31, 2024
  • An illustration of a stethoscope in the shape of a dollar sign.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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
  • Two people are seen inside a Medicare Services office.
    Image attribution tooltip
    Spencer Platt via Getty Images
    Image attribution tooltip

    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 • Jan. 30, 2024
  • A calculator and stethoscope rest on a medical bill.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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 • Jan. 29, 2024
  • A street sign for Wall Street in front of the facade of the New York Stock Exchange.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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 • Jan. 26, 2024
  • Close up shiny wooden law gavel in dark brown color on top of a wooden table in an office.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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 • Jan. 25, 2024
  • A street sign marks the intersection of Wall and Broad Streets in Manhattan.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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 • Jan. 24, 2024
  • Elevance headquarters is a large white and brown building surrounding a grassy quad.
    Image attribution tooltip
    Permission granted by Elevance Health
    Image attribution tooltip

    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 • Jan. 24, 2024
  • Two large wooden doors slightly opened. Within the opening is pictured a person looking into the room.
    Image attribution tooltip
    Nathan Howard via Getty Images
    Image attribution tooltip

    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 • Jan. 24, 2024
  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
    Image attribution tooltip
    Samantha Liss/Healthcare Dive
    Image attribution tooltip

    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 • Jan. 22, 2024
  • icons on blue screen
    Image attribution tooltip
    Getty Images
    Image attribution tooltip
    Sponsored by Pegasystems

    Adaptive 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
  • Woman working on laptop at home
    Image attribution tooltip

    Dean Drobot/Shutterstock

    Image attribution tooltip
    Sponsored by Teleperformance

    Implementing 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
  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
    Image attribution tooltip
    Samantha Liss/Healthcare Dive
    Image attribution tooltip

    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 • Jan. 19, 2024
  • A stethoscope rests on a pile of American dollar bills.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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
  • A street sign marks the intersection of Wall and Broad Streets in Manhattan.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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 • Jan. 18, 2024
  • A picture of a stethoscope on top of a notebook with blue charts and investment images overlaid over it.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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
  • Image attribution tooltip
    Scott Eisen via Getty Images
    Image attribution tooltip

    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
  • A stethoscope rests on a pile of American dollar bills.
    Image attribution tooltip
    Getty Images
    Image attribution tooltip

    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
  • The HHS in DC
    Image attribution tooltip
    Alex Wong via Getty Images
    Image attribution tooltip

    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 • Jan. 17, 2024