Thursday, March 16, 2023: Payers

As the public health emergency ends, Medicaid enrollees and the health insurance companies that cover them face major disruptions in the coming months as states resume removing people who no longer qualify for the program. A Modern Healthcare article states that an...

Tuesday, March 14, 2023: Payers

Thousands of patients have called on a federal court to reverse a landmark ruling allowing a UnitedHealth Group subsidiary to develop mental and substance abuse coverage guidelines they allege deviate from clinical standards. The American Medical Association, the...

Thursday, March 2, 2023: Payers

Health insurers’ margins in Medicare Advantage were more than double those seen in other markets in 2021, reinforcing the way the program can produce strong financial returns for plans, a new Kaiser Family Foundation analysis shows. Private Medicare plans are...

Tuesday, February 28, 2023: Payers

A new study found that Medicare Advantage (MA) had fewer avoidable hospitalizations for acute conditions compared to traditional Medicare, a trend that may be caused by shifting patients to other sites of care. The study, published in the Journal of the American...

Monday, February 27, 2023: Payers

Payers should be keeping a close eye on developments in the drug pipeline for Alzheimer’s disease therapies—and how the Centers for Medicare & Medicaid Services (CMS) responds to those developments, according to a new report from Optum. The report...

Thursday, February 23, 2023: Payers

A federal judge has temporarily forbidden a former Cigna executive from taking a position at CVS Health as part of an anti-poaching lawsuit. CVS Health hired Amy Bricker, then president of Cigna’s Express Scripts pharmacy benefit manager subsidiary, to be chief...