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 Wellcare plans filed the lawsuit Tuesday in federal court in Missouri. WHY THIS MATTERS
A new lawsuit filed in the Southern District of New York accuses Anthem Blue Cross Blue Shield of New York of maintaining a “ghost network” of doctors, with patients pursuing pricey out-of-network care and experiencing care delays due to inaccurate provider directories.
Healthcare insurtech Oscar Health will be expanding its presence on the Affordable Care Act marketplace in 2025 and is introducing new plans for people with multiple chronic conditions. The company will expand into 405 markets across 18 states next year, it said.
Elevance Health is laying off a combined 123 employees across two southern California locations, according to regulatory documents filed this month.
Medical illustrators need to take complex information and edit out what is not the physician’s focus, such as an injury. AI has not learned proper cellular anatomy, says David Bolinsky, producer of The Inner Life of the Cell and E.mersion Studios CEO and creative director.
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, according to Chris Pizzi, chief executive of the Southern Oregon Service Area.
Waltz Health, a digital health company focusing on the pricing and distribution of prescription medications, is collaborating with digital chronic disease prevention company Noom on a new weight loss program the two describe as comprehensive and more affordable.
The Tukey outlier, guardrails on cut points and the end of Chevron are factors that may influence payer challenges to low 2025 MA star ratings, says Jenn Kerfoot, chief strategy and growth officer at DUOS.
Evernorth Health Services has selected Transcarent to power its new Oncology Benefit Services program. The digital platform included in the offering is geared to bring together cancer services across pharmacy and medical benefits and provide more personalized patient support via a dedicated care team.
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 appointments, onsite lab services and virtual care support for members.