From Kraft Heinz suing Aetna for alleged mismanagement of employee claims data to Elevance Health being sued by contracted labor unions for reportedly restricting claims data access, certain ...

Public health and the rest of the healthcare delivery system have long operated in silos in the U.S. While progress was made during the COVID-19 pandemic, CDC Director Mandy Cohen, MD, stressed that ...

Optum's former senior vice president of AI products and platforms Sanji Fernando has joined healthcare-focused private equity firm Frazier Healthcare Partners. Mr. Fernando will serve as an operating ...

Value-based strategy helped Humana improve outcomes and reduce costs for patients with chronic kidney disease and end-stage renal disease. The company published an issue brief detailing its strategy ...

CMS must recalculate the Medicare Advantage star ratings for Anthem Blue Cross Blue Shield of Georgia, a federal judge ruled June 10. The judge ruled partially in favor of Elevance Health, which sued ...

Here are five lawsuits, settlements and legal developments involving payers that Becker's has reported since May 22: 1. CMS must recalculate the Medicare Advantage star ratings for Anthem Blue Cross ...

Optum has sold its workers' compensation Settlement Solutions business to ExamWorks Compliance Solutions, an Optum spokesperson told Becker's June 10. The Settlement Solutions segment was sold for an ...

Seven payers landed among the top 25 healthcare companies on the Fortune 500 in 2024. UnitedHealth Group was the largest healthcare company on the list. The healthcare giant rose one spot to No. 4, ...

A generic medication from CivicaScript saved Highmark members $90 per month on average and generated $3 million in savings for the plan, members and group customers, the insurer said in a May 29 news ...

Artificial intelligence has the potential to lower internal and member costs for insurers while also increasing profits, but the industry has largely not embraced these opportunities, according to a ...

Dual-eligible special needs plan enrollees are twice as likely to have prior authorization requests denied compared to all other Medicare Advantage members, according to KFF. According to the analysis ...

Humana's challenge to a CMS rule implementing stricter auditing standards on Medicare Advantage plans can continue, a federal judge ruled. In a June 7 order, U.S. District Judge Reed O'Connor denied a ...