As people’s health needs become more complicated, they’re looking for more support from those who help them stay healthy. What they want most is a trusted partner to guide them through the ...

Payer leaders need a flexible mindset, data know-how and big-picture thinking to succeed in 2025, according to more than a dozen executives. Becker’s reached out to 17 executives to learn what ...

UnitedHealth Group is complying with criminal and civil investigations into its Medicare Advantage business, the company said in a July 24 regulatory filing. The disclosure comes after The Wall Street ...

Humana is offering a voluntary early retirement option to some of its employees. The buyout offer will be available for certain parts of the company and for employees who meet specific eligibility ...

Aligning wound patient needs with the appropriate level of care can have a significant impact on patients, hospitals, and payors. In one recent case study, two hospitals reduced wound patients’ ...

New Hampshire Gov. Kelly Ayotte has signed a bill that requires insurers to notify the state’s insurance department at least 90 days in advance before discontinuing a line of business, including ...

CareOregon has laid off 80 employees and eliminated 70 empty positions in response to financial headwinds, the Oregonian reported July 22. According to the report, the layoffs included positions at ...

Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. None of the introduced bills have been heard in ...

AdventHealth’s Shawnee Mission Medical Center is suing Blue Cross and Blue Shield of Kansas City, alleging the insurer improperly withheld more than $2 million in payments by denying hundreds of valid ...

A former Medicare Advantage executive has been found not guilty of healthcare fraud. A jury found Kenia Valle Boza, the former director of Medicare risk adjustment analytics for HealthSun Health Plans ...

Insurers own less than 5% of primary care providers, but this share has grown significantly since 2016, a study published in the July issue of Health Affairs Scholar found. Researchers calculated the ...

Blue Cross and Blue Shield of Louisiana has lost its legal challenge against CMS over how its 2025 Medicare Advantage star ratings were calculated. On July 9, the U.S. District Court for the District ...