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Author: Jakob Emerson

Blue Cross Blue Shield of Wyoming is entering the Medicare Advantage market for 2026 coverage. In its inaugural year, WyoBlue Advantage will be available to Medicare-eligible residents in 22 of Wyoming’s 23 counties. The company will offer both a Medicare-only…

UnitedHealthcare’s prior authorization gold card program has seen a more than 40% increase in the number of qualifying provider groups in 2025, the company shared with Becker’s. Launched in October 2024, the program reduces prior authorization requirements in favor of…

Seven health-system owned insurers have named new leaders in 2025: 1. Presbyterian Health Plan, part of Presbyterian Healthcare Services, named Heather Thiltgen as its next president. 2. Baylor Scott & White Health Plan named Stephanie Motter as president. 3. Health…

The No Surprises Act is tied to an 18% decline in out-of-pocket spending among adults with direct purchase private health insurance, according to a BMJ study published Aug. 27. The analysis was conducted by researchers from Harvard University and Mass…

Medicare Shared Savings Program Accountable Care Organizations generated record savings and continued to improve quality performance in 2024, CMS said Aug. 28. In 2023, the program saw $2.1 billion in net savings. Five notes: 1. Out of 476 ACOs, 75%…

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Cigna’s Evernorth is investing $3.5 billion in Shields Health Solutions, a specialty pharmacy company launched after Walgreens went private in August.  Evernorth’s investment in Shields is in the form of preferred stock and is not expected to have a major…

Californians enrolled in Medicare Advantage are facing slower growth in healthcare costs compared to those in traditional Medicare, according to new research from the UCLA Center for Health Policy Research. Five notes: 1. Between 2013 and 2023, average monthly healthcare…

Pittsburgh-based UPMC recorded an operating income of $111.2 million (1.3% operating margin) in the second quarter of 2025, driven in part by improved underwriting margins in the insurance division, according to its Aug. 28 financial report. Insurance enrollment revenue was…

UnitedHealthcare is suing Radiology Partners and its Arizona-based affiliate, Sonoran Radiology, alleging the companies have been “abusing” the No Surprises Act’s independent dispute resolution process and “funneling millions into the pockets of its private-equity owners.” The complaint, filed Aug. 8…

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