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Medicare Advantage in the Hot Seat: Challenges and Opportunities Part 1
The first look at a preview of HealthLeaders Payer Week, five days of in-depth coverage and exclusive interviews.
Are We Any Closer To VBID-X?
Yes and no, but keep an eye on CMS' growing Value-Based Insurance Design model.
Spotlight: Healthfirst's unique approach to Value-Based Insurance Design
The payer is one of only two Medicare Advantage plans focused solely on social drivers of health in its CMS...
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Yet Another Payer Backtracks on Mandate Amid Provider Pushback
UHC is pulling back on its controversial prior authorization mandate.
Curbing the Marketing Problem in Medicare Advantage
Misleading marketing has run rampant in the private program for too long, though new CMS regulations will attempt to offer...
MA Star Ratings: A Path to Dominance or Billions in Losses?
The answer is both as payers benefit unevenly from CMS' fine turning.
It’s Time to Go Digital with Your Payments: Here’s Why
Medicare Overpaid $22.5M for Incorrect Place-of-Service Codes
The Office of Inspector General (OIG) uncovered overpayments in 2019 and 2020 for care provided to Medicare beneficiaries.
Medicare Advantage in the Hot Seat: Challenges and Opportunities Part 2
Gov. Wes Moore signs executive order protecting gender-affirming health care in Maryland
Maryland Gov. Wes Moore signed an executive order aimed at protecting gender-affirming health care throughout the state. The order will...
The rise and fall of Friday Health Plans
Friday Health Plans was dealt another blow late last week when Nevada Insurance Commissioner, Scott Kipper, filed legal action with...
Containing the ill effects of inflation on employer healthcare costs
Whether you're an employer or employee, the cost of healthcare is likely an increasing concern.
Ford suing Blue Cross Blue Shield, alleging a price-fixing conspiracy
Ford Motor Co. is suing Blue Cross Blue Shield in federal court, alleging a price-fixing conspiracy that it says resulted...
Dispute between hospital and insurer extends even to this key hospital property
With no contract resolution in sight, Northeast Georgia Health System and UnitedHealthcare can?t even agree on the status of Habersham...
UnitedHealth offers over $3 bln for home health firm Amedisys
UnitedHealth Group (UNH.N) on Monday made a surprise $3.26 billion all-cash offer to acquire Amedisys Inc (AMED.O), pitting itself against...