Broker News
Sutter Health Update on Payer Contracting in Northern California
An Update on Aetna
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CVS goes small in latest retrenchment move
The big picture: National retail pharmacies are struggling to find a winning business model in an increasingly challenging environment.
Retail pharmacies are embracing the idea that less is more as they grapple with online competitors, lagging reimbursement, sluggish consumer demand and employee burnout.
Driving the news: CVS Health this week confirmed it’s rolling out roughly a dozen downsized stores, testing the theory that getting back to the basics of dispensing drugs will be more sustainable than selling greeting cards and cosmetics.
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‘Pay attention to what we’re doing here’: 3 payers come together on new payment model in California
Aetna, Blue Shield of California, and Centene’s Health Net are teaming up on a new, shared payment model for primary care physicians in California.
The initiative, which went live at the start of 2025, is being rolled out alongside 11 providers across the state, serving around 17,000 patients. The project is backed by the California Quality Collaborative and the Integrated Healthcare Association, with the goal of tackling painpoints around primary care reimbursement, health outcomes, and disparities.
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Thought Inflation Was Bad? Health Insurance Premiums Are Rising Even Faster
Kirk Vartan pays more than $2,000 a month for a high-deductible health insurance plan from Blue Shield on Covered California, the state’s Affordable Care Act marketplace. He could have selected a cheaper plan from a different provider, but he wanted one that includes his wife’s doctor.
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Will virtual-first oral care transform employee benefits in 2025?
When it comes to health care, today’s consumer expects convenience, choice and accessibility. Although many segments of the health care industry have evolved to meet these demands, dentistry has often lagged.
The traditional reliance on physical dental offices creates barriers for many individuals and makes it challenging to prioritize oral health. What’s more, high costs, provider shortages, accessibility issues and dental anxiety frequently lead to deferred care.
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UnitedHealthcare to cut 10% of prior authorizations
UnitedHealth Group is taking another step to refine its prior authorization requirements as it continues to face public frustration.
The healthcare giant’s insurance business, UnitedHealthcare, plans to cut nearly 10% of prior authorizations this year, the company said in a notice Saturday.
READ FULL ARTICLE » https://www.modernhealthcare.com/insurance/unitedhealth-prior-authorization-home-health
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MEDICARE
March is Colorectal Cancer Awareness Month
The goal of this national health observance is to increase awareness that colorectal cancer is largely preventable, treatable and beatable. In conjunction with National Colorectal Cancer Awareness Month, the Centers for Medicare & Medicaid Services (CMS) remind health care professionals that Medicare provides coverage for certain colorectal cancer screenings. Colorectal cancer affects both men and women of all racial and ethnic groups and is most often found in people aged 50 years or older. And the risk for developing colorectal cancer increases with age.
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