Becker's Payer Issues | Payer News

Bloomington, Minn.-based HealthPartners launched its copay-only health plan, Simplica NextGen Copay, this year. The plan sets prices for in-network care without a deductible or coinsurance. Moe Suleiman, senior vice president of commercial business, and Maggie Helms, senior vice president, chief…

New Mexico has seen the biggest increase in ACA enrollment from 2025 to 2026, while North Carolina has seen the largest decrease, according to KFF. The ranking below uses preliminary CMS data comparing similar periods during the 2025 and 2026…

Anthem Blue Cross and Montage Health’s Community Hospital of the Monterey Peninsula (Calif.) are still in negotiations ahead of their end-of-month contract deadline, both organizations confirmed. The change would affect members across Anthem Blue Cross’ self-insured employer-sponsored individual plans, commercial…

The new year started off strong with a handful of payer mergers and acquisitions, often known as affiliations for nonprofits. Here are four M&A moves so far: 1. Fallon Health will join fellow nonprofit insurer Boston-based Mass General Brigham Health…

As Blue Cross Blue Shield licensee Hawaii Medical Service Association and Honolulu-based Hawaii Pacific Health prepare to form One Health Hawaii, they are going under the microscope. A Jan. 13 informational briefing run by Hawaii’s House and Senate committees on…

Kaiser Permanente has named its Colorado market president, Mike Ramseier, as senior vice president of national health plan markets. Mr. Ramseier has been with Kaiser since 2019. Before that, he served in senior leadership positions at Beacon Health Options and…

Sustained GLP-1 use slows medical cost growth, according to findings published Jan. 13 from professional services firm Aon. The firm analyzed 192,000 GLP-1 users from July 2022 to March 2025, comparing outcomes to non-users, through commercial medical and pharmacy claims…

Salt Lake City-based University of Utah Health Plans has named Michael Hales CFO, effective Jan. 1. Mr. Hales will lead the financial, actuarial and Medicaid strategy for the health plan, while continuing in his current role as associate executive director…

Alignment Healthcare has California roots, but its CEO, John Kao, is confident about planting seeds for growth elsewhere.  Mr. Kao weighed in on Alignment’s strategy Jan. 14 during the J.P. Morgan 2026 Healthcare Conference in San Francisco. Just days before,…

President Donald Trump released a sparsely detailed healthcare policy framework Jan. 15 that calls on Congress to codify voluntary drug pricing agreements with major pharmaceutical companies, direct payments to Americans over extending enhanced ACA subsidies, and expand price transparency requirements…