Cano Health Trims 700 Workers; UnitedHealth Cutting Back On Prior Authorizations

Modern Healthcare: Cano Health To Lay Off 700 Employees, Explores Sale
Membership-based primary care provider Cano Health is laying off 700 employees, exiting four markets and exploring a sale, the company said Thursday. ... Around 40% of the layoffs are tied to the company's pending exit from markets in California, New Mexico, Illinois. and Puerto Rico. Cano said it plans to exit the three states, where it has a total of 5,000 members and 17 medical centers, by the fall. It plans to exit Puerto Rico, where it serves 8,000 members, by 2024. (Perna, 8/10)

Axios: UnitedHealth Cutting Back On Prior Authorizations
Starting next month, UnitedHealthcare says it will move forward with plans to drop prior authorization requirements for a range of procedures, including dozens of radiology services and genetic tests, among others. UnitedHealth is among the health insurance giants who have announced plans to cut back on prior authorization as federal regulators consider tougher curbs on the practice. (Reed, 8/10)

Modern Healthcare: Kaiser, UnitedHealth To Earn Big Medicare Advantage Star Bonuses, KFF Says
Kaiser Permanente will receive the biggest per-member bonus from the Medicare Advantage star ratings program in 2023, an analysis found. The Centers for Medicare and Medicaid Services will pay the integrated health system's insurance arm $523 per member for its high performance in the federal quality bonus program, according to a report published by KFF Wednesday. (Tepper, 8/10)

Houston Chronicle: Medicare Advantage Undergoing Aggressive Changes From Biden
New rules went into effect this summer designed to stop insurance companies that administer Medicare Advantage plans from denying care that typically would be covered by Medicare. That follows changes earlier this year on how medical costs are assessed and new restrictions limiting how Medicare Advantage plans, which typically offer additional coverage such as vision and dental and put limits on out-of-pocket costs, are marketed to seniors. (Osborne, 8/10)

The Philadelphia Inquirer: Independence Blue Cross, Penn Medicine, Jefferson Health, Others Commit To Eliminating Race-Based Medicine
Independence Blue Cross and 12 Philadelphia-area health systems, including Jefferson Health and Penn Medicine, on Thursday announced an effort to phase out race as a factor in clinical guidelines used to make treatment decisions. “Race-based medicine has driven or contributed to the unacceptable health inequities that we see in the Philadelphia region and in other similarly situated communities across the country,” Independence CEO Gregory E. Deavens said in a news release. (Brubaker, 8/10)

Also —

Stat: Large Hospital System Sues Multiplan For Low-Balling Medical Claims
AdventHealth, a large religious-affiliated hospital system, has sued MultiPlan, alleging the company has worked with health insurers to create a “cartel” that systematically underpays hospitals and doctors for care that is delivered out of an insurance company’s network. (Herman, 8/10)

KFF Health News: Your Exorbitant Medical Bill, Brought To You By The Latest Hospital Merger 
When Mark Finney moved to southwestern Virginia with his young family a decade ago, there were different hospital systems and a range of independent doctors to choose from. But when his knee started aching in late 2020, he discovered that Ballad Health was the only game in town: He went to his longtime primary care doctor, now employed by Ballad, who sent him to an orthopedist’s office owned by Ballad. That doctor sent him to get an X-ray at a Ballad-owned facility and then he was referred to a physical therapy center called Mountain States Rehab, which was now owned by Ballad as well. (Rosenthal, 8/11)