Becker's Payer Issues | Payer News

Several major payer acquisitions have closed or were announced in 2025.  19 deals to note:  Blue Cross and Blue Shield of Kansas City (Mo.) and Highmark shared plans to affiliate, while the local Blues plan will keep its brand and…

Turquoise Health has detailed its first comprehensive payer price transparency scores in its 2025 impact report, evaluating machine-readable file quality across 97 payers.  Ten key findings: 1. Turquoise Health now tracks 219 payer files monthly. The company has assigned transparency…

Blue Cross and Blue Shield of Kansas City (Mo.) and Highmark are affiliating. While this is far from Highmark’s first affiliation agreement, there is not a one-size-fits-all blueprint. Four leaders from the organizations spoke with Becker’s about how the arrangement…

Optum executives spoke with Becker’s throughout 2025 about how the company is applying AI and data analytics to address inefficiencies across the healthcare system, from claims processing delays and operating room bottlenecks to pharmacy operations and value-based care delivery.  What…

Coming into 2025, health insurance industry leadership encountered overwhelming uncertainty. Despite this, 2025 proved to be a year of executive mobility. Here are 19 payer CEO moves from this past year: 1. Krista Nelson will lead Optum Health as CEO. …

Nearly half of health plan coverage denials that reached independent medical review were overturned between 2019 and 2023, with significant variation by state, according to a Health Affairs study published Dec. 10. Researchers from the University of California San Francisco…

Kaiser Permanente is the largest insurer by enrollment in the fully insured large group market, UnitedHealth Group is the largest within the fully insured small group market, and Centene is the largest within the individual market, according to the Peterson-KFF…

Throughout 2025, health insurance leaders have weighed in on the role AI should play in the industry, from advancing operational efficiencies to integrating with consumer-facing technology. Here are 14 statements and updates on AI from health insurers in 2025: 1.…

UCare is laying off roughly 250 employees in early January as the Minneapolis-based nonprofit insurer moves toward shutting down, the Minnesota Star Tribune reported Dec. 12. Another 650 workers are expected to transition to jobs at Medica, which announced in…

Neither bill proposing solutions to the impending ACA enhanced subsidy expiration survived a Dec. 11 Senate vote. While Senate Democrats advocated for a three-year ACA tax credit extension, Republicans pitched an alternative focusing on health savings accounts. Both motions failed…