by Jordana Choucair | Feb 8, 2023 | Payers
Centene expects to lose an estimated 2.2 million Medicaid members during the redetermination process over the next 18 months, which would significantly dial back the insurer’s pandemic-era growth. For full-year 2022, Centene reported $1.2 billion in profit, down...
by Jordana Choucair | Feb 3, 2023 | Payers
A new Kaiser Family Foundation analysis found that Medicare Advantage (MA) plans denied two million (six percent) of the 35 million prior authorization requests for health care services in whole or in part in 2021. The analysis also finds that, in general, insurers...
by Jordana Choucair | Feb 2, 2023 | Payers
The Centers for Medicare & Medicaid Services (CMS) released the advance notice of methodological changes for Medicare Advantage (MA) capitation rates and payment policies for MA and Part D. The notice includes a 2.09 percent rate increase and a 1.03 percent...
by Jordana Choucair | Feb 1, 2023 | Payers
Blue Shield of California announced it is partnering with Accolade to launch a new virtual-first health plan. Beginning April 1, members who choose the Virtual Blue plan will be able to access a slew of virtual health services – including 20 different types of...
by Jordana Choucair | Feb 1, 2023 | Inequities and SDOH, Payers
Kaiser Family Foundation (KFF) released two new analyses exploring the demographics of the 12.5 million dual eligibles and the spending associated with this population. According to the analyses, 87 percent of dual eligibles had an income of less than $20,000 in 2020,...
by Jordana Choucair | Jan 31, 2023 | Payers
The Biden administration finalized a rule that will implement audits of Medicare Advantage (MA) insurers in an effort to identify and recover overpayments. Medicare projects to get back $479 million for audits of 2018 plans, and the government expects to recoup $4.7...
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