Budgeting
An average of 3.2% of all claims denied include those that are preapproved via the prior authorization process.
The organization attributes the results to its insurance business units, notably Highmark Health Plans and HM Insurance Group.
Eighty four percent of health systems cite lower reimbursement from payers as a top cause of low operating margins.
The percentage of America's rural hospitals operating in the red jumped from 43% to 50% in the last 12 months, the biggest leap yet.
The company said it plans to use the funding to help expedite its product roadmap and advance AI foundation models for medicine.
For 2023, Centene logged $2.7 billion in profit and $154 billion in revenue, both year-over-year improvements.
MGMA: Since plans often benchmark their rates based on the Medicare Physician Fee Schedule, the low rates underscore the negative impact of the cuts.
Optum Rx forced pharmacies to grant it discretion in calculating DIR fees they had to pay, the lawsuit claims.
Federal pandemic funding to the health sector was $174.6 billion in 2020, but just $2 billion in 2022, report says.
The organization attributes these results to the positive performance of its insurance businesses.