Companies operating under the payvider business model, such as VNS Health and Humana Inc. (NYSE: HUM), have pointed to the ability to provide a more integrated care experience, as well as an increased engagement with value-based care, as a key differentiator. For Humana, the clearest example of leveraging its integrated care to engage in value-based […] The post Payviders Differentiate Through Integrated, Value-Based Care appeared first on Home Health Care News.| Home Health Care News
The coming year is expected to be an even more “intense and disruptive” period for Medicare Advantage, as rising utilization, pharmacy costs and shifting market dynamics put new pressure on plans, while also creating opportunities for provider-sponsored models. Becker’s connected with Don Antonucci, CEO of Providence Health Plan, to discuss how the organization is thinking […]| Becker's Payer Issues | Payer News
Fitch affirmed UnitedHealth Group’s “AA-” rating July 30 but revised the company’s outlook to negative from stable. Fitch said the revision reflects new information disclosed by UnitedHealth during its second quarter earnings call held July 29. “The company provided guidance on its significantly diminished operating performance for the remainder of 2025, which suggests that it […]| Becker's Payer Issues | Payer News
UnitedHealthcare is the largest insurer in the United States by membership, and Optum is the largest employer of physicians in the country. Here's 50 things to know about healthcare giant UnitedHealth Group.| Becker's Payer Issues | Payer News
UnitedHealth Group is under criminal investigation by the Justice Department for alleged Medicare Advantage fraud, The Wall Street Journal reported May 14. Citing individuals familiar with the matter, the outlet said the DOJ has been investigating the company since at least last summer over its MA business practices, but exact criminal allegations are unclear. UnitedHealth […]| Becker's Payer Issues | Payer News
Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in 2024 are here. Payers fined by states in 2025:| Becker's Payer Issues | Payer News
