Competitive / Operational Strategy
Signals classified into this topic vertical.
61 signals
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A tale of 2 retailers: What drives success for co-branded Medicare Advantage plans
In August, SCAN Health Plan announced a partnership with Costco Wholesale Corp. to sell insurance products for older adults. Sound familiar? Costco is not the first retailer to partner with a Medicare Advantage insurer. Kroger has worked with Select Health and Priority Health on co-branded MA plans in 2023 and 2024. Websites outlining Select Health […] The post A tale of 2 retailers: What drives success for co-branded Medicare Advantage plans appeared first on Becker's Payer Issues | Payer Ne...
SCANSCAN Health Plan · 11 signals · last 30 days -
Trump Administration Announces $76 Million to Strengthen Regional Coordination and Modernize Healthcare Technology for New York
Trump Administration Announces $76 Million to Strengthen Regional Coordination and Modernize Healthcare Technology for New York This federal investment will strengthen regional partnerships, improve coordination of care, and expand access to healthcare services for rural New Yorkers
Competitive / Operational Strategy · 38 signals · last 30 days -
Trump Administration Invests $25 Million to Modernize Healthcare Technology, Expand Telehealth, and Improve High-Speed Internet Connectivity Across Michigan
Trump Administration Invests $25 Million to Modernize Healthcare Technology, Expand Telehealth, and Improve High-Speed Internet Connectivity Across Michigan This federal investment will help expand access and upgrade technology so doctors and patients can better connect and coordinate care across Michigan
Competitive / Operational Strategy · 38 signals · last 30 days -
STAT+: Top Boston hospitals clash over Medicare Advantage network after split
First, Mass General Brigham split with Dana-Farber. Now its Medicare Advantage plan is dropping the cancer hospital.
Competitive / Operational Strategy · 38 signals · last 30 days -
Scan.com raises $220M to expand US medical imaging network
The company plans to use the funding to further expand its U.S. network of imaging providers, as well as invest in its API and agentic AI infrastructure.
SCANSCAN Health Plan · 11 signals · last 30 days -
IBX expands subsidized degree opportunities for employees
Independence Blue Cross is expanding its professional development opportunities for employees through a new partnership with Reading, Pa.-based Alvernia University. According to a Sept. 1 news release, the IBX University Partnership Deferral Program allows eligible employees to pursue undergraduate and graduate degrees with tuition support: an annual allowance of $5,250. Payments are deferred until an […] The post IBX expands subsidized degree opportunities for employees appeared first on Bec...
Blue CrossBlue Cross Blue Shield plans · 20 signals · last 30 days -
Louisiana’s Medicaid contract with Elevance-BCBS venture to end, affecting 290,000
The Louisiana Department of Health’s Medicaid managed care contract with Healthy Blue, formed as a joint venture between Blue Cross and Blue Shield of Louisiana and Elevance Health, will end Dec. 31. More than 290,000 Medicaid members currently have Healthy Blue, according to a Sept. 1 news release from the department. While Medicaid eligibility does […] The post Louisiana’s Medicaid contract with Elevance-BCBS venture to end, affecting 290,000 appeared first on Becker's Payer Issues | Payer...
Elevance Health + Blue Cross Blue Shield plans · 29 signals · last 30 days -
CHI St. Vincent no longer part of Blue Cross Blue Shield of Arkansas network
CHI St. Vincent will not be part of the Blue Cross Blue Shield of Arkansas network after the Little Rock-based hospital system and the insurer failed to reach an agreement on renewing their contract, both sides announced Tuesday. The two failed to reach an agreement during negotiations over the past several months about how much […]
Blue Cross Blue Shield plans · 20 signals · last 30 days -
UnitedHealthcare taps CEO for Washington state Medicaid plan
UnitedHealthcare Community Plan of Washington has named Scott Williams as CEO. According to an August LinkedIn post, Mr. Williams will work with members, providers, community groups, tribes and state leaders in his role with the Medicaid managed care plan. Prior to this position, Mr. Williams was a vice president of network contracting with UnitedHealth Group. […] The post UnitedHealthcare taps CEO for Washington state Medicaid plan appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcare · 34 signals · last 30 days -
Florida sues 2 PBMs over alleged price fixing
Florida Attorney General James Uthmeier has filed a lawsuit against Prime Therapeutics and Cigna’s Express Scripts, alleging the pharmacy benefit managers entered into an illegal horizontal price-fixing agreement that threatens access to affordable medications. The lawsuit alleges the competitors entered a “collaboration” in December 2019 under which Prime, which is owned by BCBS plans, adopted […] The post Florida sues 2 PBMs over alleged price fixing appeared first on Becker's Payer Issues...
Cigna + Blue Cross Blue Shield plans · 29 signals · last 30 days -
‘Fundamentally different priorities’: Lee Health to go out of network for UnitedHealthcare members
Fort Myers, Fla.-based Lee Health said it would terminate hospital and physician contracts with UnitedHealthcare at the end of 2026. Beginning Jan. 1, 2027, Lee Health will be out of network for UnitedHealthcare employer-based, individual and Medicare Advantage plan members. Lee Health said UnitedHealthcare does not consider the health system to be part of the […] The post ‘Fundamentally different priorities’: Lee Health to go out of network for UnitedHealthcare members appeared first on Beck...
UnitedHealthcareUnitedHealthcare · 34 signals · last 30 days -
Opinion: A billing code was supposed to incentivize relationship-based primary care for Medicare patients. It may not be working as hoped
Primary care is much more than what happens during an office visit, writes physician Ishani Ganguli.
Competitive / Operational Strategy · 38 signals · last 30 days -
Arkansas BCBS, CommonSpirit’s CHI St. Vincent near contract deadline
Arkansas Blue Cross and Blue Shield and Little Rock, Ark.-based CHI St. Vincent, under Chicago-based CommonSpirit Health, are nearing their Sept. 1 contracting deadline without an agreement. On Sept. 1, CHI St. Vincent — including its four hospitals, 80 medical clinics and more than 300 providers — could leave all provider networks for Arkansas BCBS […] The post Arkansas BCBS, CommonSpirit’s CHI St. Vincent near contract deadline appeared first on Becker's Payer Issues | Payer News .
Blue Cross Blue Shield plans · 20 signals · last 30 days -
Federal court rejects PhRMA challenge to Medicare drug price negotiation
A federal appeals court on Wednesday ruled against a lawsuit filed by representatives of the pharmaceutical industry challenging the federal Medicare drug price negotiation program, finding that drugmakers are not entitled to sell their products to Medicare at a price they would prefer. The U.S. Court of Appeals for the 5th Circuit affirmed a prior...
Competitive / Operational Strategy · 38 signals · last 30 days -
Optum Rx taps employer, government markets president
Mona Chitre, PharmD, will serve as the market president for the newly created employer and government markets segment under Optum Rx, UnitedHealth Group’s pharmacy benefit manager. Dr. Chitre will begin her role Aug. 31, according to an Aug. 26 LinkedIn post. She said the role unifies the commercial, health system, coalition, labor and trust, and […] The post Optum Rx taps employer, government markets president appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 34 signals · last 30 days -
Cigna to manage NFL’s behavioral health network
Cigna Healthcare will manage a new behavioral health network for eligible current and former National Football League (NFL) players and their eligible dependents beginning Sept. 1. The NFL and NFL Players Association (NFLPA) created the Behavioral Health Network as an enhancement to the NFL Player Insurance Plan, according to an Aug. 26 news release from NFLPA. Cigna […] The post Cigna to manage NFL’s behavioral health network appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 10 signals · last 30 days -
Trump Administration Announces $3.15 Million to Expand Pharmacy Connectivity Throughout Rural Ohio Communities
Trump Administration Announces $3.15 Million to Expand Pharmacy Connectivity Throughout Rural Ohio Communities This federal investment will improve interoperability and management of patient healthcare coordination
Competitive / Operational Strategy · 38 signals · last 30 days -
A look inside the expanded partnership between SCAN and Costco
SCAN Group and retailer Costco are expanding their partnership with the launch of new cobranded Medicare products.
SCANSCAN Health Plan · 11 signals · last 30 days -
Blue Cross and Blue Shield of Illinois marks two years of progress through expanded special beginnings program
Blue Cross and Blue Shield of Illinois announced the second anniversary of its expanded Special Beginnings® Maternal and Infant Health Initiative, highlighting investments and partnerships supporting healthier outcomes for moms […]
Blue Cross Blue Shield plans · 20 signals · last 30 days -
BCBS Tennessee pivots away from AI program that monitored employee work
BlueCross BlueShield of Tennessee has moved away from AI software that monitored employee work, according to an Aug. 19 report from the Chattanooga Times Free Press. The insurer confirmed to Becker’s that it recently ended a pilot based on employee feedback. The company had been using Skan AI, a platform that observes workflows and business […] The post BCBS Tennessee pivots away from AI program that monitored employee work appeared first on Becker's Payer Issues | Payer News .
BCBS TennesseeBlue Cross Blue Shield plans · 20 signals · last 30 days -
Only 13% of Medicare beneficiaries can accurately define coverage options: Survey
There’s widespread gaps in Medicare knowledge among both current beneficiaries and adults approaching eligibility for the program, even as most enrollees express high confidence in their understanding of the program, according to a new eHealth survey. The findings, released Aug. 20, were based on nationwide surveys of 1,000 adults conducted by a third-party vendor from […] The post Only 13% of Medicare beneficiaries can accurately define coverage options: Survey appeared first on Becker's Pay...
eHealtheHealth · 1 signal · last 30 days -
Humana names chief medical officer
Humana tapped Shantanu Nundy, MD, to serve as the company’s chief medical officer, effective Aug. 31. According to an Aug. 20 news release, Dr. Nundy will inform the company’s AI use, products and platforms. He will report to Humana President and CEO Jim Rechtin, serving on the company’s enterprise leadership team. “I am confident Shantanu’s […] The post Humana names chief medical officer appeared first on Becker's Payer Issues | Payer News .
HumanaHumana · 13 signals · last 30 days -
Costco enters Medicare market through SCAN partnership
SCAN Health Plan and Costco will roll out insurance products for older adults in the coming years, according to an Aug. 18 news release. The Wall Street Journal reported that the companies would begin by selling jointly branded Medicare Advantage products in two states, as well as a Medicare supplement in a third state. While the geography was […] The post Costco enters Medicare market through SCAN partnership appeared first on Becker's Payer Issues | Payer News .
SCANSCAN Health Plan · 11 signals · last 30 days -
Four health systems, including Ochsner and Denver Health, go live with Epic's real-time prior authorization checks
UnitedHealthcare, Network Health and Aetna are among the first group of health plans to go live with the API, while Ochsner Health, Froedtert ThedaCare Health, Denver Health and Summit Health are the four health systems now using the real-time prior auth checks.
UnitedHealthcareAetnaUnitedHealthcare + CVS Health / Aetna · 42 signals · last 30 days -
Providence Health Plan's Medicare Advantage sale falls through
After exploring options for the future, including a sale, Providence Health Plan announced this week that it will cease operations for most of its insurance businesses next year.
Competitive / Operational Strategy · 38 signals · last 30 days