5+ hour, 28+ min ago  (309+ words) The Senate voted along party lines Thursday to defeat Democrats’ attempt to end WISeR, which they argue is delaying Medicare beneficiaries’ needed care. The Wasteful and Inappropriate Service Reduction model is a mandatory experiment launched in six states this year…...

2+ day, 3+ hour ago  (1259+ words) Elevance has struggled to dig itself out of a trough in the safety-net insurance program, which has been dogged by a mismatch between low state payment rates and high member acuity. Elevance Health is shrinking its Medicaid business, worried about…...

2+ day, 3+ hour ago  (910+ words) Physician groups said the sweeping rule is a double-edged sword, given it includes an unwelcome fee cut but positive changes to Medicare’s largest value-based care program. Physicians billing Medicare would see a pay dip next year as part of a…...

3+ day, 5+ hour ago  (11+ words) Healthcare Dive...

3+ day, 23+ hour ago  (407+ words) SCAN Health Plan and Alignment Healthcare both filed lawsuits against the CMS last week after regulators refused to recalculate industry-wide MA scores using the same methodology as for Clover Health. More insurers are filing lawsuits in an attempt to hike…...

1+ week, 4+ hour ago  (501+ words) The Houston-based nonprofit is the latest integrated system to throw in the towel on some of its insurance plans amid a tough cost and policy environment. Memorial Hermann is one of the largest nonprofit systems in southeast Texas, operating 14 hospitals…...

1+ week, 23+ hour ago  (548+ words) David Joyner’s assurances, which come about a month before CVS is scheduled to report second quarter results, will likely be welcomed by investors wary after a difficult few years for insurers. CVS’ insurance division Aetna has a finally gotten a…...

1+ week, 2+ day ago  (667+ words) The review found almost 97% of diagnoses found in HouseCalls visits were backed up by patients’ medical records, vindicating its integrity, UnitedHealth said. A newly released audit of UnitedHealth’s home visits for Medicare seniors found little evidence to support accusations that…...

2+ week, 1+ day ago  (434+ words) Regulators recalculated plans’ quality scores last month after losing a lawsuit to Clover Health. But they used a different methodology for Clover than its peers, spurring Elevance’s lawsuit. Insurers have never been shy about contesting their MA stars, given the…...

2+ week, 1+ day ago  (15+ words) Healthcare Dive...