Blue Cross Blue Shield groups weigh potential cost sharing strategies

The Wall Street Journal reports that Highmark Inc. is, with other health groups, part of very early-stage discussions regarding “combining some operations to share costs.” The talks apparently include Blue Cross-affiliated companies including Philadelphia’s Independence Health Group, the parent company for Independence Blue Cross, according to the paper. “The parent of Independence Blue Cross is[…]


Medicare to cut payments to employer-sponsored Advantage plans

A new federal proposal would slash over payments made to Medicare Advantage plans sponsored by employers and unions years after an advisory board recommended the policy. The CMS proposed terminating the bidding process for employers and unions that offer 2017 Medicare Advantage plans to their retirees. The policy was included in the recent 228-page Medicare[…]


UPMC analysis contends Highmark no longer top insurer in Western Pa.

More people in Western Pennsylvania now have health insurance from UPMC than from Highmark Inc., according to a UPMC analysis, marking a potential milestone in the rivalry between the nonprofits. Highmark, which for decades has dominated the region’s health insurance market, declined to say Thursday whether it has arrived at the same conclusion. “Highmark will[…]

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Justice Department investigating Humana billing practices

Humana Inc. reports that it is cooperating with a Department of Justice inquiry into whether it exaggerated the severity of elderly patients’ illnesses to generate higher Medicare reimbursements. The Louisville, KY-based firm disclosed the Justice Department’s “information request” in its annual report filed Feb. 18 with the Securities and Exchange Commission, according to a Center[…]

Medicare Advantage funding could be cut

Supporters of Medicare Advantage program are roundly criticizing President Obama’s fiscal 2016 budget plan to slash more than $36 billion in its funding over the coming decade. In a Feb. 2 statement from the Better Medicare Alliance, interim executive director Krista Drobac said the cuts would only exacerbate the financial burden on enrollees who already[…]