Author's posts
CMS reduces navigator funding to $10 million
The Centers for Medicare and Medicaid Services has reduced funding for the Affordable Care Act Navigator Program to $10 million, ultimately with the goal of reducing premiums.
According to CMS, the savings from the reduction will allow Federally-Facili…
Evernorth, NBA partner on community health
Evernorth Health Services, a division of Cigna, has entered into a multi-year partnership with the NBA and the WNBA on a campaign to improve community health, making it the official health services partner of the two leagues.
The collaboration also mak…
Class action lawsuit against UnitedHealth’s AI claim denials advances
A federal judge has dismissed five out of seven counts in a class action lawsuit against UnitedHealth Group but will allow it to continue, with the suit claiming that UHG, UnitedHealthcare and naviHealth denied claims by using an artificial intelligenc…
Miller Children’s launches pediatric care network
Miller Children’s and Women’s Hospital in Long Beach, California is kick-starting a new network to provide primary and specialty pediatric care.
California insurers launch primary care model
Three California-based health plans – Aetna, Blue Shield of California and Health Net – have come together to implement a shared value-based payment model under the California Advanced Primary Care Initiative’s Payment Model Demonstration Project.
Humana cites rate increases, utilization in $693M Q4 loss
Humana’s financial results for Q4 and for full-year 2024 show a 10% revenue increase, but that’s about the only bright spot as the insurer was hit by significant losses, according to its Q4 earnings results.
Rising healthcare utilization and insufficie…
Aetna’s high medical costs hammer CVS earnings
CVS Health’s profits took a dip year-over-year, with the company reporting $1.6 billion in profits in Q4 2024, down from the $2 billion it brought in at the end of 2023.
Profits for the full year hit $4.6 billion – a sizable hit from the $83 million in…
Behavioral health should shift to value-based care despite challenges, Evernorth says
Basing payment on clinical outcomes rather than the volume of service is increasingly common among medical practitioners, yet value-based reimbursement is less common among mental health practices. According to a new paper published by Evernorth, a Cig…
Most Medicaid adults are working, KFF analysis finds
Four years ago, the Biden administration rolled back a controversial rule that required Medicaid beneficiaries to work in order to receive coverage.
Mobile Healthcare does house calls
Monadnock Community Hospital (MCH) in Peterborough, New Hampshire has enacted a mobile healthcare program to close care gaps in nearby rural communities.
