Category: Payer Issues

Health Insurance Companies Think They’re Differentiating in 2022 … But Are They?

It’s no secret that the HR function has become more complex in recent years. Thanks to policy changes in State Paid Sick Leave, the Affordable Care Act, demands brought forth by the #MeToo movement (among other changes), today HR professionals have the…

10 recent payer exec moves

From the Blue Cross Blue Shield Association finding its top-level information security officer to Colorado Access making history with its new president and CEO — the first woman and person of color to hold the position — here are 10 recent payer execut…

Record 14.5 million Americans signed up for health insurance under ACA

A record-setting 14.5 million Americans signed up for health coverage since open enrollment began Nov. 1. 

Cigna discussed potential acquisition with Centene in late 2021

Cigna discussed a potential acquisition of Centene in the final months of 2021, but nothing has come of the preliminary conversations, according to a Jan. 26 Bloomberg report. 

A better methodology for managing payer cost allocations — 4 takeaways

The rapidly changing healthcare landscape, along with unrelenting pressure to control costs, challenges payers to find better ways to manage the complex cost allocation processes.

Anthem in headlines: 5 stories

From a 2021 earnings report with mixed takeaways to leadership earning one of the National Collegiate Athletic Association’s highest honors, here are five recent headlines involving Anthem:

2 insurers withdraw appeal over North Carolina Medicaid contract award

Two North Carolina payers — Aetna Better Health Care and My Health by Health Providers of Morrisville — are stepping away from the table after suing the state’s health and human services department in 2019 over its Medicaid contract, according to the T…

Biden administration seeks Medicare coverage of at-home COVID-19 tests

President Joe Biden is exploring requiring coverage of at-home COVID-19 tests for Medicare beneficiaries in addition to private commercial members, according to a Jan. 26 report from The Wall Street Journal. 

Anthem operating gain hits $7.5B, but commercial growth flounders: 10 things to know

Anthem reported $137 billion in year-end revenue for 2021, anchored by government market and pharmacy growth as commercial development seems to stall. 

It’s Time to Go Digital with Your Payments: Here’s Why

Electronic claim payment trends all point to one dynamic: faster turnaround. Simply put, businesses and consumers now expect near-immediate access to funds when they have been given notice of transfer. Luckily, that era of real-time digital payments is…