Oregon health regulators have flagged three payers for “unreasonably high healthcare cost growth in 2023.” In an October report, the Oregon Health Authority said that Moda Health’s Medicare Advantage plans increased costs by 15.4%, PacificSource’s commercial plans grew 7.3%, and…
Author: Jakob Emerson
Vermont has the highest average ACA benchmark premium in 2026, while New Hampshire has the lowest, according to KFF. The U.S. average is $625. Premiums were analyzed using the second-lowest cost silver plan premium for a 40-year-old in each county…
Dual eligible special needs plans, or D-SNP, are the fastest growing segment of Medicare Advantage, as insurers increasingly focus on complex populations amid broader margin pressures within the program. At Becker’s 4th annual Fall Payer Issues Roundtable, Michael Carson, president…
Blue Shield of California has named Gary Culp as senior vice president of government markets and Greg Siebert as senior vice president for provider partnerships and network management. Mr. Culp will lead Blue Shield’s government health programs, including Medicare, Medi-Cal,…
The Cigna Group is consolidating its board committee structure, dissolving its standalone compliance committee and redistributing oversight responsibilities across other committees, effective Jan. 1. The board approved the changes in late October, according to an SEC filing. The restructuring follows…
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Centene is putting its money where its mouth is when it comes to individual coverage health reimbursement arrangements. The managed care giant is transitioning more than 700 Indiana-based employees to ICHRA in 2026, becoming one of the most notable endorsements…
A federal jury in Florida has convicted an insurance brokerage president and the CEO of a marketing company for their roles in a scheme to fraudulently enroll individuals in subsidized ACA plans to obtain commission payments from insurers. The scheme…
Aetna is rolling out a generative AI-powered conversational assistant within its website and mobile app. The new tool synthesizes member benefits, provider networks and program information to deliver answers in plain language, eliminating the need for users to understand industry…
Molina Healthcare has been selected by the Florida Agency for Health Care Administration to administer a specialized Medicaid and CHIP program for low-income and underserved children. Molina was the sole plan selected and expects to serve approximately 120,000 enrollees of…
Blue Cross and Blue Shield of Massachusetts reported a year-to-date net loss of $101.4 million on revenue of $7.7 billion (-1.3% net margin) and expects to end the year with operating and net losses. The most recent financial results reflect…