US health giant UnitedHealth facing fraud probe: WSJ
Insurance giant UnitedHealth Group is facing a criminal investigation by the US Justice Department for possible Medicare fraud, the Wall Street Journal reported Wednesday.
May 15, 2025
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Health Care Economics and Organizations: News and Research on Legislation, Hospital
MeSH tree: N03.706.615.420
When hospitals ditch Medicare Advantage plans, thousands of members get to leave, too
For several years, Fred Neary had been seeing five doctors at the Baylor Scott & White Health system, whose 52 hospitals serve central and northern Texas, including Neary's home in Dallas. But in October, his Humana Medicare ...
Apr 30, 2025
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Rural hospitals question whether they can afford Medicare Advantage contracts
Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with ...
Apr 10, 2025
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Mehmet Oz confirmed as head of Centers for Medicare & Medicaid Services
The U.S. Senate has confirmed the appointment of Mehmet Oz, M.D., to head the Centers for Medicare & Medicaid Services (CMS), according to a report from The New York Times.
Apr 9, 2025
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Coding differences in Medicare Advantage plans led to $33 billion in excess revenue to insurers, study finds
An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers receive as a result.
Apr 7, 2025
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Medicare Advantage is covering more and more Americans, some because they don't get to choose
Since the mid-2000s, the Medicare system has dramatically transformed. Enrollment in Medicare Advantage—the private alternative to the traditional Medicare program administered by the government—has more than quadrupled. ...
Apr 3, 2025
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Lowering the cost of insurance in Colorado: A new analysis of the Peak Health Alliance
A community-led partnership in Colorado designed to negotiate health care prices lowered health care premiums in 2020 and 2021, we find in our new paper in the Journal of Risk and Insurance. The nonprofit organization is ...
Apr 3, 2025
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Current radiologist shortage projected to persist to 2055
The current radiologist shortage is projected to persist, and projected imaging utilization is projected to continue increasing through 2055, according to two studies published in the February issue of the Journal of the ...
Feb 27, 2025
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Researchers find Medicare Advantage beneficiaries do not receive more dental, vision or hearing care
As the privatized form of Medicare, Medicare Advantage plans advertise dental, vision, and hearing benefits not covered by traditional Medicare, but a recent analysis found that Medicare Advantage beneficiaries do not typically ...
Jan 14, 2025
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After UnitedHealthcare shooting, industry insider talks about problems in health care
The fatal shooting of a health care executive in New York City this month touched off a fierce debate about the systemic problems in health care, and the bigger-picture role of health insurance companies.
Dec 16, 2024
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