Health Payer Specialist is a news service from the Financial Times covering the business of running commercial and nonprofit-run health plans.healthpayerspecialist.comJoined September 2019
It's not your imagination: as Medicaid rolls have shrunk, people covered by the insurance have been sicker, and now there are numbers to prove it. ow.ly/3C8A50STcRV
In our latest explainer, Health Payer Specialist looks at the contentious, and highly litigious, issue of scoring bids in the government-funded program. Watch on Health Payer Specialist. ow.ly/hTAj50Sa36G
The veteran prosecutor’s former colleagues tell Health Payer Specialist what payers can expect from the new federal task force set up under her leadership: ow.ly/abKq50RNwYU
While there may not be many more stalled contract disputes at this point than last year, a new analysis from FTI Consulting finds both sides are holding out longer and the new strategy is “don’t cave.” ow.ly/U2Lz50RzAZJ
Already dealing with steep losses and a complicated business pivot, Clover Health is now in danger of being delisted from the Nasdaq stock exchange. ow.ly/RwGR50RattR
Investors dumped shares of Humana and UnitedHealth Group after the Biden administration stood its ground on proposed Medicare Advantage rates for 2025, disappointing payers that had lobbied to get a boost in the payments. ow.ly/3VuM50R7sGK
Complaints filed with state regulators against UnitedHealth Group jumped 30% last year. Our table shows that about four-fifths of the complaints against UnitedHealth Group are clustered around only three companies within the family. ow.ly/FezF50R5TgM
U.S. Supreme Court seems unlikely to ban the use of mifepristone in abortions, probably avoiding significant disruptions to the operations of payers and pharmacy benefit managers. Read the full article on Health Payer Specialist. ow.ly/fkIc50R3cKS
Molina Healthcare and Commonwealth Care Alliance opted out of Rhode Island's second attempt to bid its Medicaid contract. Continue reading this story on Health Payer Specialist. ow.ly/l6Y150QIM8o
CVS Health executive Prem Shah, who heads the company’s pharmacy and consumer wellness units, has raised over $2 million selling company stock. ow.ly/KyOy50QG8ZS
Star performers are the target for the highest raises and a shift to quality of care and customer satisfaction from financial metrics is in store for health insurance executives this year, human resource specialists say. ow.ly/XTQK50QBkNy
Rising medical costs have been in the headlines this month. See these top 10 lists of the health insurers (large, mid-size, and small) whose medical loss ratios climbed the most during the first nine months of 2023. ow.ly/lLw550QvsXA
More states might be signing up for a new federally funded cost-containment program, and that could turn out to be frustrating for payers. Read more: ow.ly/XLRE50QrLft
From the rising cost of specialty drugs and care to reduced Medicare Advantage bonuses after changes to the star rating system. Here are the major concerns that payers and others identified when we reached out to them. ow.ly/WRo550QqsF1
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