�������ýҕ�l

One-third of adults with private insurance are contending with medical debt, according to a new survey, showing how healthcare coverage isn’t a guarantee of protection from financial devastation. About 37% of those with medical debt drained all or or part of their savings to pay their bills, and 30% delayed necessary care, according to the survey released Thursday by the Commonwealth Fund. Another 30% reported cutting back on food, heat or rent to make ends meet. (Hughes, 9/18)

Health Care Service Corp. is making major cuts to its Medicare Advantage business a little more than a year after its $3.3 billion deal with Cigna Group. The Blue Cross and Blue Shield licensee plans to withdraw completely from the Connecticut, New York and District of Columbia Medicare Advantage markets, according to a notice distributed Thursday to third-party marketing organizations. The company entered these markets through the Cigna deal last year. (Tepper, 9/18)

Molina Healthcare is pulling its all of its Medicare plans from three states for the 2027 plan year, the company notified third-party marketers Friday. The health insurer announced in February that it would completely exit the national market for individual Medicare Advantage plans to focus on Dual Eligible Special Needs Plans, or D-SNPs, for people who qualify for both Medicare and Medicaid. The company tried to sell the individual Medicare Advantage business but failed to find a buyer. (Tepper, 9/18)

Elevance Health is facing another lawsuit over its policy penalizing out-of-network referrals. As of July 1, hospitals and ambulatory surgery centers in New York that refer Anthem Blue Cross Blue Shield commercial plan members to out-of-network providers or facilities may be subject to a 7.5% pay reduction under the policy. Neurological Surgery Practice of Long Island sued Elevance Health on Thursday, claiming the physician group is “irreparably harmed” by the policy. (Tong, 9/18)

Blue Shield of California announced Thursday that it plans to expand its Virtual Blue program, doubling program enrollment for members. Beginning in January 2027, the benefit will be included in fully insured preferred provider organization (PPO) plans for employers with 101 to 3,000 employees, as well as for certain individual and family plans, the insurer said. (Gleeson, 9/17)

As the healthcare industry sloughs off inefficient and outdated processes, private equity investors see value in backing technology-driven solutions. Healthcare technology aimed at provider and payer operations ranges from revenue cycle management and prior authorization tools to clinical data platforms. The technology can make healthcare delivery less complex by simplifying workflows and reducing expenses, which can lead to stronger margins and improved patient outcomes. (Hudson, 9/18)

The appeal of telehealth is easy to explain: Instead of calling a doctor, booking an appointment and hoping to eventually get a prescription, you can log onto an app or website and get approved for a new medication within minutes. Since the COVID-19 pandemic, scores of online health services have launched with the promise of quick, convenient access to drugs for ADHD, sexual dysfunction, anxiety, weight loss and more. (Perrone, 9/19)