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58+ min ago (312+ words) More than 4,000 people who have appointments scheduled with UNC Health in December are scrambling. The patients have Cigna health insurance, and their insurer's'contract expired this week'with UNC Health. Cigna members who use UNC Health systems will need to find a new provider, or pay much higher, out-of-network prices, or choose to pay out of pocket entirely. UNC Health provided a statement about its negotiations with Cigna. WRAL News has gotten questions from viewers who are worried about when insurance contracts expire for their health care providers. A viewer asked WRAL News how to find out when insurance companies" contracts with health care companies are renewed.' The companies do not make it easy to find out'when those contracts expire. In March 2024,'UnitedHealthcare'reached a long-term deal with UNC Health and Duke Health. "While our contract has not been extended, and WakeMed is…...

2+ hour, 57+ min ago (146+ words) Astera Labs Expands Connectivity Portfolio with Custom Solutions New Partnership Strengthens Value-Based Care Platform for Primary Care Providers HENDERSON, Nev.--(BUSINESS WIRE)-- P3 Health Partners (P3) (NASDAQ: PIII) and Commonwealth Primary Care ACO (Commonwealth) recently announced the formation of a Joint Venture Management Services Organization (MSO) for its ACO lines of business designed to expand value-based care and enhance support for primary care physicians across Arizona, California, Nevada, Oregon, and North Carolina. Under the JV, P3 and Commonwealth ACO entities will remain independent but will share operations under a unified structure, with P3 serving as the majority owner. The JV will be governed by a joint board, with teams from both organizations collaborating to streamline operations, share best practices, and expand support for PCPs across the network. About Commonwealth Primary Care ACO, LLC About P3 Health Partners (NASDAQ: PIII) Source: P3 Health Partners Inc....

3+ hour, 23+ min ago (479+ words) As health care costs continue to soar across the U.S., a growing number of states are setting limits on how much hospitals can charge. These policies, known as hospital payment caps, aim to curb spending by tying hospital prices to Medicare rates, which are typically far lower than what commercial insurers pay. In 2019, Oregon became the first state to implement such a cap, applying it to the health plan covering state employees. Under the policy, hospitals cannot charge the state more than double the Medicare payments for the same service. For example, if Medicare pays $1,000 for a service, the state health plan would pay no more than $2,000 under this cap." The researchers looked at financial, staffing and patient experience data from 22 Oregon hospitals affected by the cap and compared them to similar hospitals in other states from 2014 through 2023. This included financial…...

6+ hour, 2+ min ago (138+ words) Health insurer Aetna and St. Louis-based BJC Health are nearing an agreement that will keep the health care provider'in Aetna's coverage network next year, both sides reported Tuesday. Without a new agreement, BJC Health will be out of Aetna's coverage network employer-sponsored commercial plans, starting Jan. 1. The former Homer G. Phillips Memorial Hospital closed after less than a year. A company affiliated with publicly-traded Nutex Health says it w" This year, 41% of physicians and other providers said their claims are denied more than 10% of the time, up from 30% of providers who said tha" BJC joins Mercy and SSM Health in announcing major Wentzville projects. Aetna said earlier this year it would pull out of the ACA marketplace for 2026. Missouri Baptist Medical Center in Town and Country on Jan. 2, 2024....

7+ hour, 41+ min ago (296+ words) The Member of Parliament for Garu and a member of the Health Committee, Dr. Thomas Anaba, has endorsed the government's decision to increase tariffs for healthcare service providers under the National Health Insurance Scheme (NHIS), describing it as a necessary step to improve healthcare delivery. His comments come after the Health Minister, Kwabena Mintah Akandoh, at the Government Accountability Series on Monday, December 1, revealed plans to significantly adjust NHIS tariffs upward. The Minister said the move responds to persistent complaints from health facilities that the current tariff structure is unrealistic and financially unsustainable. Speaking on Channel One Newsroom on Tuesday, December 2, the Garu MP noted that the increase is justified, especially after the government uncapped the NHIS levy to make more resources available for the scheme. According to him, the increment will provide hospitals with the financial capacity they have…...

8+ hour, 1+ min ago (255+ words) PHOENIX " An OB-GYN provider in Arizona announced Tuesday it was ending its contract with Blue Cross Blue Shield of Arizona and dropping the insurer from its network. MomDoc, a health care provider with 17 locations across Arizona, said as of Dec. 1, it would no longer be contracted with BCBSA. The CEO of MomDoc said the organization could no longer "afford to subsidize underpaying commercial plans." "This decision follows over two years of attempting to engage in meaningful discussions with BCBSAZ to secure fair and sustainable reimbursement rates that reflect the rising costs of delivering quality healthcare," MomDoc wrote in a statement. MomDoc went on to describe the difficulty of being able to recruit and retain high-quality OB doctors to Arizona. Patients insured through BCBSA will continue to have access to their MomDoc medical records and assistance will be provided to transition…...

8+ hour, 12+ min ago (240+ words) Drug and hospital prices are top employer healthcare concerns as costs rise, but some employers are unable to access their data, finds a survey by the National Alliance of Healthcare Purchaser Coalitions. Employer healthcare costs continue to rise, with high-cost claims and high drug and hospital prices being the biggest concerns, according to the most recent Pulse of the Purchaser survey by the National Alliance of Healthcare Purchaser Coalitions, released in September. (See Table Below) The survey of employers and purchasers found that they continue to want transparency from their pharmacy benefit managers (PBMs) and access to data; however, some are struggling to get the information they need. A third of employers said they cannot get complete claims data, and 4 in 10 said their vendors refused to provide access. Anne Chiang, MD, PhD; Baidehi Maiti, MD, PhD, FACP Anne Chiang, MD,…...

8+ hour, 14+ min ago (80+ words) TRICARE Open Season ends Tuesday, Dec. 9. Now is the time to review your TRICARE coverage for 2026.[TRICARE Open Season ends Dec. 9: Last chance to change your health plan for 2026] TRICARE Open Season ends Dec. 9: Last chance to change your health plan for 2026 FALLS CHURCH, VIRGINIA, UNITED STATES Defense Health Agency /search/unit/DHA /rss/unit/3361 TRICARE Open Season ends Tuesday, Dec. 9. Now is the time to review your TRICARE coverage for 2026....

8+ hour, 19+ min ago (388+ words) The city of Olathe has extended its open enrollment window to Wednesday, Dec. 3, for city retirees facing significant premium increases in their health insurance costs next year. A retired city employee first reached out to KSHB 41 about this last month, citing a recent Olathe City Council meeting. At the meeting, multiple retirees said the city's health insurance premium increases could raise their health care costs by 500% to 900% in 2026, depending on their plan and coverage level. During an open enrollment help session at the end of November for retired Olathe city employees, city officials announced they would provide a $250 per month subsidy for certain health insurance plans. "The City Manager's Office understands that changes to the retiree health insurance plan for 2026 were shared with less than advance notice than many would have preferred, and we recognize that this has caused undue…...

8+ hour, 32+ min ago (847+ words) After facing a substantial deficit for 2026 and 2027, the North Carolina State Health Plan (SHP) now has a surplus, thanks to an increase in premiums, funding from the General Assembly, and other cost-cutting measures. Friedman said their trend this year is running higher than in previous years, and part of that is due to how the plan's third-party administrator, Aetna, pays its claims. The plan's original projected deficit was $507 million in 2026 and between $800 million and $900 million in 2027. In August, the board agreed to raise plan premiums for the first time on a sliding scale based on income, with the smallest increases going to the lowest-paid state employees. The scale is broken down into four income brackets: Under $50,000; $50,001 to $65,000; $65,001 to $90,000; and $90,001 and over. Former State Treasurer Dale Folwell maintained a policy of not increasing premiums, but using cash reserves to offset increases,…...