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Industry Challenge According to the recent Gartner report on “How Clinical Data Improves US Healthcare Payer Interoperability,” health plan leaders…
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Industry Challenge According to the recent Gartner report on “How Clinical Data Improves US Healthcare Payer Interoperability,” health plan leaders are counting on the integration of clinical data “locked in provider’s electronic health records” to enable a host of needed…
Cigna Healthcare offers the best digital experience to commercial members, while UPMC Health Plan provides the best experience to Medicare Advantage enrollees, according to J.D. Power’s 2025 U.S. Healthcare Digital Experience Study. Overall, the digital experience offered by health insurers…
UnitedHealthcare is suing Broadcom, alleging that the tech giant is looking to impose “exorbitant price increases” on software used by the insurer. The heavily redacted lawsuit, filed in the U.S. District Court for Minnesota on April 2, claims that Broadcom…
CMS will increase payments to Medicare Advantage plans by more than $25 billion in 2026. The agency published the final rate announcement for MA plans April 7. According to CMS, MA plans can expect a payment increase of 5.03% in…
Independence Health Group, the parent company of Independence Blue Cross, reported a net loss of $239 million in 2024. The company’s consolidated revenue was $32 billion, up $1 billion compared to 2023. Independence cited cost pressures in its Medicaid and…
Groups representing insurers praised CMS’s final rule for Medicare Advantage in 2026. In a statement published April 4, Better Medicare Alliance President Mary Beth Donahue called the rule the “right decision to protect seniors and the Medicare Advantage program.” “As…
UCare reported an operating loss of $504 million in 2024 amid rising costs in its Medicare Advantage and managed Medicaid businesses, the Minnesota Star Tribune reported April 3. The company posted revenue of nearly $6.3 billion, a margin of about…
CMS has fined seven payers a total of more than $430,000 for violating Medicare requirements related to Part D prescription drug benefits. The insurers were penalized April 1 for errors within their formulary and benefit administration, coverage determinations, and appeals…
Artificial intelligence (AI) has dominated conversations among health plans and providers because of its potential to transform the industry. From predictive models for disease onset to chatbots answering member questions, the number of potential AI applications are innumerable. Yet, not…
Blue Cross and Blue Shield of Alabama has named Joe Dunsmore senior vice president and CIO, according to a post on his LinkedIn page. Mr. Dunsmore has been with the company for 16 years and most recently served as deputy…