Tag: Molina Healthcare
Payers move deeper into TPA model, according to poll
May 1, 2026Theresa Flaherty, Managing Editor
YARMOUTH, Maine – The accelerating shift to third‑party administrators (TPAs) appears to be gaining steam: Ninety‑two percent of respondents to a recent HME Newspoll say payers are already using or transitioning to this model, and most of the rest expect it within a year.
“I think this has the potential to be very disruptive and negative for small DMEs,” wrote one respondent. “The TPAs don’t seem interested in engaging suppliers of our size that have a personal...
Providers push back on accelerating benefits management model
April 10, 2026Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Molina Healthcare’s plan to use CareCentrix and its DME Navigator solution in four states is drawing criticism from home medical equipment (HME) stakeholders, who say the model significantly reduces reimbursement, threatens patient access to care and adds unnecessary administrative layers.
Molina Healthcare has selected CareCentrix – which developed DME Navigator with OptumInsight – to manage all lines of business effective June 1, 2026, in Illinois, Washington...
Molina Healthcare taps DME Navigator to streamline provider workflows
March 24, 2026HME News Staff
LONG BEACH, Calif. – Molina Healthcare of Illinois (MHIL) on March 2 announced the implementation of a new DME Navigator program for all lines of business effective June 1, 2026.
“DME Navigator is an end-to-end solution operated by Optum and CareCentrix leveraging the CareCentrix DME provider network,” the company stated in a memo. “Using a digital DME Navigator Point-of-Care (POC) platform powered by Parachute Health, it streamlines provider workflows and reimagines how...
Aeroflow Health provides nutrition services to Molina Healthcare members
December 16, 2025HME News Staff
ASHEVILLE, N.C. - Aeroflow Health has a new partnership with Molina Healthcare of South Carolina to offer in-network nutrition counseling and diabetes self-management education (DSME) services to the insurer’s commercial and Medicare members throughout the state. Through Aeroflow’s comprehensive Nutrition Therapy Program, Molina South Carolina members now have access to an online network of qualified dietitians who specialize in educating patients on...
In brief: CGMs save money, Aeroflow Health signs Molina, AdvaMed names chair
December 15, 2025HME News Staff
ST. PETERSBURG, Fla. – Use of continuous glucose monitors (CGMs) among individuals with diabetes treated with bolus insulin is associated with a nearly 20% reduction in total health care costs and a 23% decrease in acute care utilization over one year, according to a new study from CCS. Yet approximately 80% of eligible patients remain without a CGM prescription, the study says.
CGM users experienced total health care costs of...