Takeaways from the most recent news in the technology and policies shaping healthcare.
Insurers and the rules of getting paid: coverage, prior authorization, claims, denials, and the friction between health plans and the providers they reimburse.
Illinois plans to award new Medicaid managed care contracts to six insurers, mostly incumbents, with Humana the only newcomer.
Why it matters: State Medicaid contracts mean tens of billions in recurring revenue and shape coverage for millions of low-income residents.
Optum is cutting 92 jobs in California, mostly from the closure of an Oxnard management services organization, per June 1 regulatory filings.
Why it matters: The cuts show that even the largest payer-owned care delivery operations are trimming local footprints as cost pressure mounts on UnitedHealth Group.