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Molina beats financial expectations on higher premium revenue
Unlike Q3 earnings reports from insurers more heavily in the Medicare Advantage market, Medicaid-based Molina Healthcare on Thursday released third quarter financials that beat expectations.
Centene sues CMS over Medicare Advantage star ratings
Centene has joined the list of insurers that are suing the Centers for Medicare and Medicaid Services over the 2025 Medicare Advantage Star Ratings.
Centene of Missouri and 10 affiliated plans such as Meridian Health Plan of Michigan and several Wellca…
Providence Health & Services in Oregon optimizes value-based care
Value-based care has long been the goal, but becomes more than aspirational when the majority of patients are paying through Medicare and Medicaid.
Providence Health & Services in Medford, Oregon has a payer mix of 60% Medicare and 20% Medicaid, accord…
Cleveland Clinic and Amazon One Medical collaborate on primary care clinics
The Cleveland Clinic and Amazon One Medical are collaborating on primary care clinics in Northeast Ohio.
Amazon One Medical said it would open its first primary care office in affiliation with the Cleveland Clinic next year, offering same and next-day…
Humana sues over 2025 Medicare Advantage Star Ratings
Humana has sued the Centers for Medicare and Medicaid Services over the results of the 2025 Medicare Advantage and Part D Star Ratings.
Humana sues over 2025 Medicare Advantage Star Ratings
Humana has sued the Centers for Medicare and Medicaid Services over the results of the 2025 Medicare Advantage and Part D Star Ratings.
HIMSSCast: AI as assistant, not replacement
Data is the lifeblood of AI, said Sundar Shenbagam, chief technology officer at Edifecs.
The challenge is having a uniform way to collect the data and maintain it to make sure it remains secure. Once that’s established, data can be managed to come up w…
Karen Lynch exits CVS, David Joyner appointed president and CEO
CVS Health President and CEO Karen Lynch is out at the company amid Friday’s release of preliminary financial guidance for the third quarter that fell short of Wall Street forecasts.
Lynch stepped down from her position per agreement with the company’s…
Elevance stock slides on lower forecast
Elevance Health has reported net income of $1 billion during the third quarter, compared to $1.3 billion during the same period in 2023, a 22.5% decrease.
However, for the nine months ending September 30, net income is $5.5 billion, an increase when co…
Medicaid to cover traditional Tribal community healthcare
For the first time, the Centers for Medicare and Medicaid Services is allowing Medicaid coverage of traditional healthcare practices provided by Indian Health Services facilities, Tribal facilities and urban Indian organizations.
