UnitedHealth Group reported fourth-quarter and full-year 2025 earnings Jan. 27. Profits took a hit, with the company attributing drops to Medicare funding reductions, the Inflation Reduction Act, steeper medical costs and remaining Change Healthcare cyberattack costs. UnitedHealth Group Full-year revenue…
Author: Elizabeth Casolo
Settling into 2026, prior authorization continues to be a contentious topic for payers, providers, lawmakers and other leaders. From piloting prior authorization in Medicare to governors pitching reforms, this year is already featuring major shifts. Here are seven prior authorization…
The new year started off strong with a handful of payer mergers and acquisitions, often known as affiliations for nonprofits. Here are five M&A moves so far: 1. North Dakota regulators approved an affiliation between BCBS North Dakota and Cambia…
When the CEO of behavioral health payer and managed care organization Magellan Health thinks about AI, its use falls into several buckets. But the verdict on whether AI can replace providers is unclear. Caroline Carney, MD, of Centene subsidiary Magellan…
Anthem Blue Cross and Montage Health’s Community Hospital of the Monterey Peninsula (Calif.) have established an agreement Jan. 26, just ahead of their end-of-month contract deadline, both organizations confirmed in a news release shared with Becker’s. The agreement keeps members…
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Dane Street is now certified as a federal independent dispute resolution entity, CMS said in a Jan. 26 email. The No Surprises Act intends to prevent surprise billing through its IDR process, which is designed to settle payment disputes between…
Republican Gov. Greg Abbott is pressing the Texas HHS Office of the Inspector General and HHS Commission to investigate the state’s Medicaid program for fraud, according to a Jan. 16 letter. The push comes weeks after the federal HHS froze…
North Dakota regulators signed off on an affiliation between BCBS North Dakota and Cambia Health Solutions Jan. 23, a news release said. The affiliation is set to take effect Feb. 1. “Reaching this milestone puts us one step closer to…
Angle Health Co-founder and CEO Ty Wang thinks recent CMS and FDA initiatives will set a precedent that goes beyond Medicare. The “Advancing Chronic Care with Effective, Scalable Solutions Model” from CMS and “Technology-Enabled Meaningful Patient Outcomes for Digital Health…
Minneapolis-based Hennepin Healthcare filed a notice of intervention Jan. 22 to interject itself into insurer UCare’s rehabilitation. UCare planned to hand over its Medicaid and ACA businesses to fellow insurer Medica in 2026 as its Medicare Advantage line discontinues. In…