Today's Top 20 Stories
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Humana wants Medicare Advantage AI lawsuit thrown out
Humana is seeking to dismiss a class action lawsuit alleging the insurer used an AI algorithm to wrongfully deny Medicare Advantage beneficiaries care. -
Where Johns Hopkins Health Plans is driving growth, facing headwinds in 2024
Johns Hopkins Health Plans serves more than 470,000 members across managed care and commercial health plans. -
Lawyers made millions from Centene settlements: Report
Private lawyers made at least $108 million in fees from payments Centene made to states to settle overcharging allegations, The New York Times reported March 21.
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6 payers among top-rated workplaces, per their employees
Six insurers are among Top Workplace's 2024 honorees. -
10 providers seeking payer contracting talent
Ten providers recently posted job listings seeking leaders in payer contracting and relations. -
Medicare Advantage rates 'baffling,' lawmakers say
A group of Republican lawmakers are asking CMS to reconsider its proposed 2025 rates for Medicare Advantage. -
3 ways Medicare Advantage affects primary care physicians
There are few statistically significant differences between the way primary care physicians treat patients in Medicare Advantage and fee-for-service Medicare, according to the Commonwealth Fund.
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10 recent payer partnerships
From chronic disease management to mental health investments, these are 10 partnerships announced by health insurers within the last year: -
Georgia Medicaid work requirement program spending more on consultants than care: Report
Georgia's alternative to expanding Medicaid under the ACA has cost $26.6 million through Dec. 31, with 90% of that money going toward administrative and consulting costs, KFF Health News reported March 20. -
10 greatest payers for job starters: Newsweek
Ten health insurers were named to Newsweek's list of "America's Greatest Workplaces for Job Starters 2024." -
States lacking in Medicaid denial oversight, government watchdog says
States and CMS can increase their oversight of denials by Medicaid managed care organizations, according to a report from the Government Accountability Office.
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Centene subsidiary to reimburse hospitals' health equity accreditation costs
Meridian Health Plan of Illinois will reimburse a portion of the certification fees for hospitals that participate in The Joint Commission's Health Care Equity Certification. -
UnitedHealth, Amedisys deal under more scrutiny
Oregon regulators will open a review into UnitedHealth Group's proposed acquisition of Amedisys, after a preliminary report found the deal could hurt competition in the state's markets. -
NewYork-Presbyterian, Aetna reach deal
New York City-based NewYork-Presbyterian has reached a deal with insurer Aetna after weeks of negotiations. -
Elevance Health's specialty care acquisition spree
Elevance Health has picked up several specialty pharmacy and care-based companies in recent years, bolstering the capacity of its health services arm, Carelon. -
Mount Sinai, UnitedHealthcare reach multiyear agreement
UnitedHealthcare and New York City-based Mount Sinai reached a multiyear contract agreement March 19, effective immediately, after a monthslong contract dispute. -
The 10 best health insurance companies of 2024
Kaiser Permanente is the best U.S. health insurance company in 2024, according to Insure.com's annual ranking. -
Highmark Health Plans posts $400M margin for 2023
Highmark Health posted an operating income of $533 million on revenues of $27.1 billion in 2023, bolstered by membership growth in its health plans, the company said. -
Regence BCBS of Utah names medical director
Regence BlueCross BlueShield of Utah has named Mike Woodruff, MD, as executive medical director. -
CMS adds new ACO model: 5 things to know
CMS will introduce a new payment model designed to spur innovation in primary care for Medicare beneficiaries.
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