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Increase in self-pay patients coinciding with Medicaid redeterminations
The proportion of self-pay patients began increasing for emergency department, hospital and primary care visits in April, when states could start terminating Medicaid coverage for patients who no longer met requirements following the COVID-19 pandemic,…
Insurers’ outlook stable as 2023 nears its end, says Moody’s
Despite some challenges, the financial picture for health plans remains stable as the year comes to a close, finds a new report from Moody’s Investors Service.
Froedtert Health purchases Ascension Wisconsin’s stake in Network Health
Froedtert Health and Ascension Wisconsin have signed an agreement that will allow Froedtert to purchase Ascension Wisconsin’s interest in Network Health, a provider of customized commercial and Medicare health insurance plans.
Each organization current…
UnitedHealth AI algorithm allegedly led to Medicare Advantage denials, lawsuit claims
A class action lawsuit filed this week alleges that healthcare giant UnitedHealth Group unlawfully used an artificial intelligence algorithm to deny rehabilitative care to sick Medicare Advantage patients.
The suit claims that UnitedHealth knew the AI …
Nurse practitioner workforce grows 8.5%
The shortage of nurses and other healthcare professionals has made the industry’s workforce landscape challenging for several years now, but good news was delivered this week by the American Association of Nurse Practitioners, which released data showi…
Blue Shield of California targets maternal health with Mahmee partnership
Blue Shield of California is strengthening its relationship with maternal healthcare technology company Mahmee, with the latter’s services now available to more BSCA members.
As part of Blue Shield’s Maternal Child Health Equity Initiative, the nonprof…
Northwell Health invests $350 million into pediatric mental health
As the number of children and adolescents in need of mental health support continues to increase, New York-based healthcare giant Northwell Health is investing $350 million over the next five years, and launching a $150 million fundraising campaign to …
Optum Rx moves 8 insulins to ‘preferred’ status in bid to reduce costs
At the start of next year, pharmacy services company Optum Rx will place eight preferred insulin products on Tier One of standard commercial formularies, limiting out-of-pocket spend to $35 or less.
The UnitedHealth Group subsidiary said this action i…
Senate Finance Committee targets PBM reform in new legislation
In a unanimous 26-0 vote, the Senate Finance Committee passed a comprehensive draft package this week that puts pharmacy benefit manager reform and mental health in the spotlight.
Pharmacists treating hypertension could save health system $1.1 trillion
The U.S. healthcare system could stand to save more than $1.1 trillion over the next 30 years while preventing roughly 15 million heart attacks if pharmacists were more involved in treating hypertension, according to research from Virginia Commonwealth…
