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Underlying shifts in payer mix resulting from the changes in the exchanges were generally in line with expectations, CEO Sam Hazen said.
The approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services.
Cost control, Carelon integration and scaling AI are reasons for the company's confidence.
Insurers can expect shrinkage in the individual market and a deterioration in the risk pool, says Wakely report.
The bill is aimed at prohibiting large health insurers, such as UnitedHealthcare, from controlling a PBM or physician group.
Hospitals are on the receiving end of patients coming through the door who don't have the funds to cover services, says Seth Cohen, president of Cedar.
The non-binding committee will make recommendations on, among other issues, ways to modernize MA risk adjustment and quality measurement.
KFF survey shows the effect of the expiration of enhanced premium tax credits at the end of 2025.
Healthcare is one of the few areas where technology adds time, says Dr. Brian Silverstein of Innovaccer.
A strong MFN law could be a meaningful step toward bringing U.S. prices in line with those paid by other high-income countries, says Patients for Affordable Drugs Now.
