# Becker's Payer * **Definition:** Becker's Payer is a news source that focuses on healthcare finance, insurance, and payer-related news, providing insights, analysis, and updates relevant to healthcare providers, payers, and industry stakeholders. * **Taxonomy:** Key Sources / Healthcare Publications / Becker's Payer ## News * Selected news from the source **Becker's Payer**, for healthcare technology leaders * 861 news items are in the system for this source * Posts have been filtered for tech-related keywords | Date | Title | Topics | | --- | --- | --- | | 5/27/2025 | [**Anthem Blue Cross of California expands behavioral network: 5 things to know**](https://www.beckerspayer.com/payer/anthem-blue-cross-of-california-expands-behavioral-network-5-things-to-know/) | [[Mental Health]]; [[Strategy]]; [[Health]] | | 5/23/2025 | [**AHIP warns of 'unprecedented' coverage losses**](https://www.beckerspayer.com/policy-updates/ahip-warns-of-unprecedented-coverage-losses/) | [[Health]]; [[Leadership]]; [[Healthcare]] | | 5/23/2025 | [**Medicare Advantage in the headlines: 7 recent updates**](https://www.beckerspayer.com/payer/medicare-advantage-in-the-headlines-7-recent-updates-16/) | [[Leadership]]; [[Medicare]]; [[Strategy]] | | 5/23/2025 | [**UnitedHealthcare, Bon Secours face network split in South Carolina**](https://www.beckerspayer.com/contracting/unitedhealthcare-bon-secours-face-network-split-in-south-carolina/) | [[Roadmap]]; [[Healthcare]]; [[Health]] | | 5/23/2025 | [**BCBS Minnesota adds new substance use, eating disorder partnerships**](https://www.beckerspayer.com/virtual-care/bcbs-minnesota-adds-new-substance-use-eating-disorder-partnerships/) | [[Behavioral Health]]; [[Partnerships]]; [[Virtual Care]] | | 5/23/2025 | [**California payer decries 'hostile takeover' amid local Medicaid changes**](https://www.beckerspayer.com/payer/california-payer-decries-hostile-takeover-amid-local-medicaid-changes/) | [[Medicaid]]; [[Leadership]]; [[Strategy]] | | 5/23/2025 | [**Claims denial rates up, prior auth denials down in 2024: Report**](https://www.beckerspayer.com/payer/claims-denial-rates-up-prior-auth-denials-down-in-2024-report/) | [[Strategy]]; [[Healthcare]]; [[Claims Denials]] | | 5/22/2025 | [**Aetna delivers $20M in value-based payments: 3 notes**](https://www.beckerspayer.com/payer/aetna-delivers-20m-in-value-based-payments-3-notes/) | [[Population Health]]; [[Healthcare]]; [[Strategy]] | | 5/14/2025 | [**SCAN Group acquires full ownership of PACE organization**](https://www.beckerspayer.com/m-and-a/scan-group-acquires-full-ownership-of-pace-organization/) | [[Regulatory Approvals]]; [[Collaboration]]; [[Strategy]] | | 4/23/2025 | [**Do higher premiums drive more healthcare usage?**](https://www.beckerspayer.com/payer/do-higher-premiums-drive-more-healthcare-usage/) | [[In-Home Care]]; [[Health Systems]]; [[Insurance Coverage]] | | 4/3/2025 | [**From volume to value: The shift in healthcare that's helping put patients first**](https://www.beckerspayer.com/leadership/from-volume-to-value-the-shift-in-healthcare-thats-helping-put-patients-first/) | [[Patient Outcomes]]; [[Value-Based Care Shift]]; [[Population Health]] | | 3/26/2025 | [**Optimizing member engagement for effective population health management**](https://www.beckerspayer.com/leadership/optimizing-member-engagement-for-effective-population-health-management/) | [[Healthcare Disparities]]; [[Quality of Care]]; [[Partnerships]] | | 3/6/2025 | [**6 BCBS plans reporting losses in 2024**](https://www.beckerspayer.com/payer/6-bcbs-plans-reporting-losses-in-2024.html) | [[Health]]; [[Healthcare]] | | 2/27/2025 | [**Beyond Traditional Care Models: How Value-Based Partnerships Are Revolutionizing ...**](https://www.beckerspayer.com/payer/beyond-traditional-care-models-how-value-based-partnerships-are-revolutionizing-behavioral-health-outcomes.html) | [[Healthcare Cost Containment]]; [[Health Systems]]; [[Engagement]] | | 2/24/2025 | [**Humana looks to deepen meaning of 'value-based care'**](https://www.beckerspayer.com/leadership/humana-looks-to-deepen-meaning-of-value-based-care.html) | [[Healthcare Costs]]; [[Patient Experience]]; [[Medicare Advantage]] | | 2/19/2025 | [**Where 13 payers are growing in 2025**](https://www.beckerspayer.com/leadership/where-13-payers-are-growing-in-2025.html) | [[Pharma]]; [[Engagement]]; [[Social Determinants of Health]] | | 2/14/2025 | [**The state of healthcare payer marketing: Budgets, funnels and privacy in 2025**](https://www.beckerspayer.com/payer/the-state-of-healthcare-payer-marketing-budgets-funnels-and-privacy-in-2025.html?utm_campaign=payer&utm_source=website&utm_content=most-read) | [[Health]]; [[Financial Pressures]]; [[Healthcare]] | | 2/5/2025 | [**The prior authorization reform push continues**](https://www.beckerspayer.com/payer/the-prior-authorization-reform-push-continues.html) | [[Prior Authorization]]; [[Access to Care]]; [[Primary Care]] | | 1/22/2025 | [**What 6 payer execs are most excited about for 2025**](https://www.beckerspayer.com/payer/what-5-payer-execs-are-most-excited-about-for-2025.html) | [[Service Delivery]]; [[AI in Ophthalmology]]; [[Healthcare Accessibility]] | | 1/2/2025 | [**40 payer execs' industry outlook for 2025**](https://www.beckerspayer.com/payer/40-payer-execs-industry-outlook-for-2025.html) | [[Acquisition]]; [[Digital Twins]]; [[Digital Health Solutions]] | | 12/31/2024 | [**Top 10 health insurance stories of 2024 - Becker's Payer Issues**](https://www.beckerspayer.com/payer/top-10-health-insurance-stories-of-2024.html) | [[Medicare Advantage]]; [[Health Systems]]; [[Healthcare]] | | 12/30/2024 | [**An unimaginable year for UnitedHealth**](https://www.beckerspayer.com/payer/an-unimaginable-year-for-unitedhealth.html) | [[Security]]; [[Cybersecurity in Healthcare]]; [[Legal Challenges]] | | 12/27/2024 | [**Health insurers confront climate change**](https://www.beckerspayer.com/payer/health-insurers-confront-climate-change.html) | [[Community Health]]; [[Legal Challenges]]; [[Healthcare]] | | 12/12/2024 | [**FTC sends warning to 21 insurance marketing companies**](https://www.beckerspayer.com/payer/ftc-sends-marketing-warning-to-21-insurance-marketing-companies.html) | [[Communications]]; [[Compliance]]; [[Medicare Advantage]] | | 12/12/2024 | [**Data-driven solutions for maternal health**](https://www.beckerspayer.com/leadership/data-driven-solutions-for-maternal-health.html) | [[Rural Health]]; [[Virtual Care]]; [[Health Equity]] | ## Recent Stories (Some LLM-derived content — please confirm with above primary sources) ### Topics Covered - **FinancialLosses**: At least seven Blue Cross Blue Shield companies reported financial losses in 2024 due to rising medical utilization and drug costs, with BCBS Michigan facing the largest loss of $1.7 billion. - **ValueBasedCare**: Primary care doctors are increasingly recognizing the need for value-based care models to improve healthcare quality and reduce costs, with Florida Blue leading initiatives in this area. - **UnitedHealthGroup**: Shareholders withdrew a proposal for an analysis of UnitedHealth Group's business practices impacting healthcare access, while the company faces lawsuits and scrutiny over its practices. - **AIInHealthcare**: Artificial intelligence is being recognized for its potential in healthcare, with organizations like Arine emphasizing the importance of effective implementation to improve patient outcomes. - **MedicareAdvantage**: UnitedHealth Group is adjusting its Medicare Advantage strategies due to rising medical costs and unexpected high utilization rates among members. - **MentalHealthParity**: The Trump administration announced a pause on new mental health parity regulations finalized by the Biden administration, prompting discussions on potential modifications. - **DigitalHealthSolutions**: Despite the popularity of digital health solutions, adoption rates among employees remain low, highlighting the need for strategies to enhance engagement. - **MusculoskeletalCare**: There is a call for innovative approaches to musculoskeletal care, focusing on early intervention and precision medicine to improve patient outcomes. - **Medical Mutual Lawsuit**: An Ohio jury awarded Medical Mutual of Ohio over $50 million in damages after it won a lawsuit against FrontPath Health Coalition and HealthScope Benefits for fraudulent practices related to a health benefits contract with the city of Toledo. - **Legislation in Hawaii**: Hawaii lawmakers are introducing legislation to address provider concerns regarding the prior authorization process. - **Partnership Expansion**: Aledade and Humana are expanding their partnership to provide value-based care to Medicare Advantage members. - **Patient-Centered Healthcare**: Experts emphasize the need for a patient-centered approach in healthcare, addressing systemic barriers and offering diverse healthcare options. - **Behavioral Health Crisis**: The behavioral health crisis in America is worsening, necessitating innovation in behavioral health services and a shift to value-based partnerships. - **Healthcare Spending Report**: A report on healthcare spending in New York City highlights significant data gaps due to Anthem Blue Cross's refusal to release complete pricing information. - **Healthcare Marketing Challenges**: Healthcare payer marketers face challenges in driving growth while adhering to strict legal and compliance regulations. - **Medication Optimization**: Medication optimization presents a transformative opportunity to alleviate rising healthcare costs and improve patient outcomes. - **Kindred Hospitals**: Kindred Hospitals specialize in treating medically complex patients and have achieved nationally recognized certifications for disease-specific care. - **UnitedHealth Settlements**: UnitedHealth has reached multiple settlements, including a $69 million class-action lawsuit regarding its 401(k) plan and a $2.5 million settlement for violating the Telephone Consumer Protection Act. - **Pharmacy Benefit Managers**: Intermountain Health rebranded its pharmacy benefit manager to Scripius, aiming for better control over prescription costs and transparency. - **Healthcare Sector Outlook**: Moody's downgraded its outlook for the health insurance sector to negative due to high medical costs affecting earnings growth. ### Organizations Mentioned - **BlueCrossBlueShield**: A federation of independent health insurance companies providing coverage across the United States. - **FloridaBlue**: A health insurance provider focused on value-based care initiatives. - **UnitedHealthGroup**: A diversified health and well-being company offering health insurance and related services. - **Arine**: A healthcare technology company utilizing AI to enhance patient care and outcomes. - **SCANGroup**: A nonprofit health plan providing Medicare Advantage products and services. - **AetnaBetterHealth**: A Medicaid managed care organization focused on improving healthcare delivery in underserved areas. - **AHIP**: America's Health Insurance Plans, a national trade association representing health insurance providers. - **InterfaithCenter**: A coalition of institutional investors advocating for corporate responsibility. - **InterSystems**: A technology company providing data integration solutions for healthcare organizations. - **SutterHealth**: A healthcare provider in Northern California collaborating with SCAN Group on Medicare Advantage products. - **CommonwealthCareAlliance**: An organization providing integrated care for older adults, previously partnered with SCAN Group. - **McLarenHealthPlan**: A health plan serving members in Michigan, part of McLaren Health Care. - **Medical Mutual of Ohio**: A health insurance company that won a lawsuit for damages related to fraudulent practices by FrontPath Health Coalition and HealthScope Benefits. - **FrontPath Health Coalition**: A health coalition accused of manipulating the bidding process in a lawsuit against Medical Mutual of Ohio. - **HealthScope Benefits**: A benefits management company involved in the lawsuit against Medical Mutual of Ohio for fraudulent practices. - **Aledade**: A healthcare organization expanding its partnership with Humana to provide value-based care. - **Humana**: A health insurance company partnering with Aledade to enhance value-based care for Medicare Advantage members. - **Anthem Blue Cross**: A health insurance provider involved in a report regarding healthcare spending in New York City. - **Kaiser Permanente**: A leading health insurance company ranked as one of the top insurers in the U.S. for 2025. - **UnitedHealthcare**: A major health insurance company ranked alongside Kaiser Permanente as a top insurer in the U.S. for 2025.