Private Payers News

Humana and Baptist Health reach contract agreement for in-network coverage

March 18, 2024 - Kentucky-based Baptist Health Medical Group and Humana have reached a new contract agreement, restoring in-network coverage for Medicare Advantage and commercial patients. The multi-year agreement comes after Baptist Health announced in September 2023 that Baptist Health Medical Group physicians and advanced practice clinicians would no longer...


Articles

Wellcare partners with tech company to improve value-based primary care

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Wellcare, the Medicare brand of Centene Corporation, has partnered with a technology company to improve access to value-based primary care. The company, Pearl Health, focuses on physician enablement...

Health Insurance Costs Are Growing Too Expensive for Small Businesses

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While small businesses know the advantages of providing health insurance, many employers are concerned about the rising costs of health benefits, with most businesses that do not offer health insurance...

UnitedHealth Group Scrutinized for Alleged Antitrust Practices

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The Department of Justice (DOJ) is investigating antitrust allegations against UnitedHealth Group, with a specific focus on the ties between UnitedHealthcare and Optum, according to a Wall Street...

Privately Insured Adults Are Satisfied With Health Plan Coverage

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Privately insured adults are generally satisfied with their health plan coverage, valuing their low out-of-pocket costs and premiums, provider networks, and prescription drug coverage, according to...

Elevance Health’s $2.5B Acquisition of BCBSLA Paused a Second Time

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Blue Cross Blue Shield Louisiana (BCBSLA) announced that it will not move forward with plans to be acquired by Elevance Health. “We continue to hear from our stakeholders that they want Blue...

Medicare Advantage Intake Surveys May Draw Insights, But Not Always

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New Medicare Advantage plan members can self-report their health literacy status during the enrollment process, but may not be as responsive in an enrollment survey of perceived healthcare...

KLAS Report Reveals Top-Performing Vendors for Payer Services

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Using technology to assist with payer operations can help streamline workflows and relieve administrative burden. The 2024 Best in KLAS Software & Services report highlights the top-performing...

How Affordability Challenges Reveal Care Disparities for ESI Members

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Employees in employer-sponsored health plans face significant care disparities based on income, sexual orientation, and race that influence health outcomes for each group, a report from Morgan Health...

No Surprises Act Prevented 10M Surprise Medical Bills, But IDR Use Grows

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The No Surprises Act (NSA) helped prevent 10.1 million surprise medical bills in the first nine months of 2023, according to a survey from AHIP and the Blue Cross Blue Shield Association (BCBSA). The...

UnitedHealth Group Saw Revenue and Enrollment Growth in 2023

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UnitedHealth Group saw revenue growth of over 14 percent in 2023, while adding 1.7 million new consumers to its Medicare and commercial offerings, executives shared during the UnitedHealth Group Fourth...

OOP Costs Greater for Cancer Patients in High-Deductible Health Plans

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Patients with cancer enrolled in high-deductible health plans had higher out-of-pocket medical costs compared to those in traditional health plans, according to a study published in JAMA...

UnitedHealthcare Platform Improves Member Access to Well-being Programs

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UnitedHealthcare has launched a platform to facilitate member access to health and well-being programs and lower costs for employers. The UHC Hub offers a network of more than 20 health and well-being...

How One Payer Tackled the No Surprises Act Provider Directory Rule

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Brian Marsella, president of Health Payment Systems (HPS) and Paymedix, was accustomed to the challenges of maintaining provider directories when he joined HPS and Paymedix in 2022. But two years into...

Elevance Health Plans to Acquire TX-Based Infusion Therapy Provider

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Elevance Health has entered into an agreement to acquire infusion therapy provider Paragon Healthcare, improving access to specialty medication for members, the payer announced. Elevance Health plans...

US Drug Prices Are 8x the Cost in Peer Countries for Some Drugs

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Despite efforts to reduce drug costs through Medicare negotiation for 10 common medications, the US still pays more for these drugs than almost any other nation, even after factoring in discounts and...

Centene Pays South Carolina $25M to Settle Overcharging Allegations

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Centene Corporation has reached a $25.89 million settlement after allegedly overcharging South Carolina’s Medicaid program for pharmacy services. Per the settlement, Centene must pay South...

2024 Employer Sponsored Health Plan Predictions: GLP-1s, Vendors, Data

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Employers are stuck between a rock and a hard place in 2024, with unsustainable healthcare spending in their employer-sponsored health plans and a reticence to shift any more of the cost to their...

2024 Payer Strategies: Population-Based Plans, MA Differentiation

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The new year may look remarkably like 2023 from the payer perspective with a similar set of headwinds, but payer strategies may change. Health insurers will build on last year’s progress in...

Humana Awards $169K in Health Equity Grants to Community-Based Orgs

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Humana has granted $169,000 to 24 community-based organizations committed to advancing health equity, according to a press release HealthPayerIntelligence received via email. The payer’s health...