Fierce Healthcare

JANUARY 21, 2024

The health insurance giant, which serves 117 million people, sees opportunities to leverage generative AI and other technologies to make healthcare easier to navigate, chief AI officer Shawn Wang said during an interview at CES 2024.

Insurance 126

Insurance 126

STAT

FEBRUARY 5, 2024

As hospitals and health insurers release their profit projections for 2024, it’s become clear that this change — largely overlooked when it was announced — could have a marked effect on companies’ finances.

Insurance 122

Insurance Hospitals 122

STAT

MAY 20, 2024

Those trends — the same ones that tanked health insurance stocks a few weeks ago — made a strong mark on nonprofit health systems’ first quarter financial reports. That includes things like fighting insurance denials and getting better deals from vendors for key supplies like drugs and medical devices.

Insurance 118

Insurance Hospitals 118

Fierce Healthcare

OCTOBER 24, 2023

UnitedHealthcare is expanding its footprint on the Affordable Care Act (ACA) exchanges to four new states in 2024, the insurance giant

Insurance 111

Insurance 111

Fierce Healthcare

JUNE 17, 2024

LAS VEGAS — Last week, leaders across the health insurance industry descended on Sin City to dig deep into the biggest topics facing payers. | LAS VEGAS — Last week, leaders across the health insurance industry descended on Sin City to dig deep into the biggest issues facing payers.

Insurance 132

Insurance 132

Fierce Healthcare

SEPTEMBER 16, 2024

Health plans are set to rake in $11.8 billion in Medicare Advantage quality bonus payments, according to a new analysis from KFF.

Insurance 132

Insurance 132

The Checkup by Singlecare

AUGUST 15, 2024

Is Contrave covered by insurance? Insurance plans and Medicare often do not cover Contrave. Aetna’s Standard Control Plan and a Human Medicare plan are examples of ones not covering the drug in 2024. Insurance carriers’ coverage of weight loss drugs is highly variable. How much does Contrave cost without insurance?

Insurance 98

Insurance Controlled Substances FDA Labelling 98

STAT

DECEMBER 28, 2023

STAT’s taking a look at some of the recent health policy trends that states will start to implement in 2024. Some states have pioneered new programs to increase their oversight over drug costs, health care costs, and health care mergers, and those are beginning to generate both results and lessons learned.

Insurance 112

Insurance Hospitals 112

Fierce Healthcare

JUNE 18, 2024

Health insurance executives are captivated by artificial intelligences' use cases. You can’t spell AHIP without AI. Here's where they see advancements on the horizon.

Insurance 125

Insurance 125

STAT

AUGUST 4, 2023

The Centers for Medicare and Medicaid Services originally said it would cut payments meant to help safety net hospitals by $115 million in 2024. The federal government will pay hospitals that treat poor and uninsured patients almost $1 billion less next year, a cut that’s more than eight times larger than the one proposed in April.

Insurance 98

Insurance Hospitals 98

Fierce Healthcare

DECEMBER 20, 2023

Health systems, insurers, retailers like CVS and tech companies like Amazon are all scrambling for a bigger piece of the medical pie.

Insurance 133

Insurance 133

STAT

FEBRUARY 28, 2024

In 2023, enrollment in Medicare Advantage, the version of Medicare run by private insurers, surpassed 50% of eligible beneficiaries for the very first time. These insurers cited higher than average health care utilization rates as the culprit and warned that 2024 would likely see more of the same. In fact, the opposite is true.

Insurance 145

Insurance 145

Digital Pharmacist

SEPTEMBER 20, 2023

The Medicare Open Enrollment period for 2024 is quickly approaching – this is a critical time for both your patients and your pharmacy. This leaves very little time before patients need to re-evaluate their insurance. Every year, the enrollment period runs from October 15 to December 7.

Independent Pharmacies 105

Independent Pharmacies Insurance Nursing Homes Immunization 105

Fierce Healthcare

JULY 12, 2023

High-quality therapy can be expensive for a lot of individuals and it's estimated that one-third of therapists don't accept insurance at all. | The new funding will accelerate Octave’s expansion to more regions later this year and all 50 states in 2024.

Insurance 94

Insurance 94

Fierce Healthcare

APRIL 8, 2024

Health insurers are gearing up to release their first-quarter results over the next several weeks, and a new analysis from Fitch Ratings finds that ongoing concern about utilization in Medicare Adv | A new analysis from Fitch Ratings finds that ongoing concern about utilization in Medicare Advantage has made for a cloudy outlook.

Insurance 115

Insurance 115

Fierce Healthcare

SEPTEMBER 29, 2023

The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance. | The industry is just two weeks away from the beginning of Medicare's annual enrollment period, a critical window for the hottest market in insurance.

Insurance 122

Insurance 122

Fierce Healthcare

OCTOBER 8, 2024

One year ago, we brought together top minds in the health insurance industry at our first Fierce Health Payer Summit. | One year ago, we brought together top minds in the health insurance industry at our first Fierce Health Payer Summit.

Insurance 104

Insurance 104

STAT

FEBRUARY 16, 2024

million adults older than 65 and people with disabilities were enrolled in a Medicare Advantage plan as the calendar flipped to 2024 — another year of steady, albeit slower, growth for the taxpayer-funded program. Roughly 33.4 Enrollment increased 7.1% Continue to STAT+ to read the full story…

Insurance 128

Insurance 128

STAT

MAY 7, 2024

” (Read part 1 , part 2 , part 3 , and part 4 of the “Denied by AI” series.)

Insurance 117

Insurance 117

STAT

JANUARY 3, 2024

Hospitals and clinics are expecting a slightly better 2024 compared to last year thanks to a return to mostly in-person care, patients resuming preventive visits and the gradual easing of labor costs and shortages. Continue to STAT+ to read the full story…

Hospitals 120

Hospitals Insurance 120

Fierce Healthcare

AUGUST 20, 2024

Below is a roundup of payer-centric news headlines you may have missed during the month of August 2024. Care Health Plan slashed prior auth codes for catheter supplies, and Illinois signed laws cracking down on insurers involving colonoscopies, inhalers and more. This month, Devoted Health completed its series E funding round, L.A.

Insurance 126

Insurance 126

The Checkup by Singlecare

MAY 29, 2024

Is OneTouch Verio covered by insurance? With a prescription from your healthcare provider, your insurance may cover glucose testing supplies. Insurance coverage for OneTouch Verio glucose test strips will vary based on an individual plan formulary. How much does OneTouch Verio cost without insurance?

Insurance 78

Insurance Insurance Coverage 78

STAT

JANUARY 30, 2024

Copyright © 2024 by Uché Blackstock, M.D. access to health care has long depended on insurance and a person’s ability to pay, with patients of color making up a disproportionate number of the under- or uninsured, as I have seen firsthand. From “ Legacy ” by Uché Blackstock, M.D., In the U.S.,

Insurance 145

Insurance Hospitals 145

Fierce Healthcare

OCTOBER 11, 2023

Humana CEO Bruce Broussard will step down from the role in the latter part of 2024, and the insurer has already found a successor. Humana CEO Bruce Broussard will step down from the role in the latter part of 2024, and the insurer has already found a successor.

Insurance 111

Insurance 111

Fierce Healthcare

JUNE 3, 2024

Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. Blue Cross and Blue Shield of Kansas City is opting out of the Medicare Advantage market.

Insurance 124

Insurance 124

Fierce Healthcare

AUGUST 29, 2024

operating margin) halfway through 2024, the integrated nonprofit system reported in a Thursday filing. Higher volumes, rates and pharmaceutical expenses have so far spelled a tough 2024 for UPMC's insurance division. Pittsburgh-based UPMC’s operations are $313 million in the red (-2.2%

Insurance 64

Insurance 64

Fierce Healthcare

SEPTEMBER 13, 2024

Below is a roundup of payer-centric news headlines you may have missed during the month of September 2024. This month, Humana faces consequences for prior auth delays, Congress members have introduced new No Surprises Act legislation targeting insurers and Aetna has been sued for denying gender-affirming facial reconstruction surgeries.

Insurance 119

Insurance 119

STAT

JANUARY 7, 2024

Even though some of the health systems presenting at the conference just lost hundreds of millions in 2023, expect a theme of cautious optimism for the coming year from hospitals, medical groups, health insurers, and the vendors who serve them.

Hospitals 110

Hospitals Insurance 110

Fierce Healthcare

MARCH 8, 2024

LOS ANGELES—Health insurers have access to a bevy of valuable data, and the push toward interoperability made it easier for those data to be shared with providers. |

Insurance 126

Insurance 126

STAT

MAY 1, 2024

CVS Health got walloped at the outset of 2024 as older adults in its Medicare plans continue to get a lot more medical care than the company expected. The company, which absorbed the health insurer Aetna in 2018, marketed its Medicare Advantage plans aggressively last year and expanded its geographic reach more than any insurer.

Insurance 122

Insurance 122

Fierce Healthcare

SEPTEMBER 11, 2023

At a time when inflation seems to be on the nation’s radar, it’s no surprise that Blue Cross and Blue Shield of North Carolina would tout that members in the healthcare plans it offers in the Affor | The rate decrease, approved by the North Carolina Department of Insurance, will lower total premiums by an estimated $130 million for enrollees in the (..)

Insurance 118

Insurance 118

STAT

DECEMBER 27, 2023

Their increasingly ubiquitous use is having a huge impact not only on patients and the companies that manufacturer these drugs — Novo Nordisk and Eli Lilly — but also investors , doctors, employers, insurers, regulators, and businesses in a variety of industries. Continue to STAT+ to read the full story…

Insurance 111

Insurance 111

The Checkup by Singlecare

DECEMBER 31, 2024

According to Dr. Hakimi, Nurtec is typically covered by insurance, but coverage can vary depending on your specific health insurance plan. Factors affecting Aetnas converge of Nurtec Pfizer , the manufacturer of Nurtec, says most insurance companies are likely to cover Nurtec. Does Aetna cover Nurtec?

Insurance 52

Insurance FDA 52

Fierce Healthcare

NOVEMBER 26, 2024

Pittsburgh-based health insurer and provider Highmark Health has brought in $529 million in net income through the first three quarters of the year, according to its latest financial details releas | Highmark Health has brought in $529 million in net income through the first three quarters of the year, according to its latest financial details.

Insurance 93

Insurance 93

STAT

APRIL 16, 2024

The almost $8 billion UnitedHealth made on operations in the first three months of 2024 was roughly the same as the prior-year period.

Insurance 119

Insurance Hospitals 119

STAT

JUNE 4, 2024

The federal government inappropriately lowered the 2024 Medicare Advantage star ratings of SCAN Health Plan, which led to the health insurance company in California losing hundreds of millions of dollars in bonuses from the government, a judge ruled Monday.

Health Insurance Companies 132

Health Insurance Companies Insurance Hospitals 132

STAT

JANUARY 18, 2024

Humana’s Medicare Advantage enrollees got care in the hospital and physician clinics way more often than the company predicted at the end of 2023, forcing the health insurance giant on Thursday to drastically slash its profit projections for both 2023 and 2024.

Insurance 110

Insurance Hospitals 110