Author: Jakob Emerson

There’s “a hunger for a different kind of dialogue” when it comes to relations between payers and providers, according to Aetna President Steve Nelson. Mr. Nelson laid out a vision for Aetna that centers on rebuilding trust in the industry,…

Optum has launched Value Connect, an AI-powered platform designed to help payers and providers operationalize value-based care models by combining clinical, operational and financial data into a single system. The platform uses AI across quality measures, utilization patterns and risk…

One in 10 Medicare Advantage enrollees were forced to disenroll from their health plan heading into 2026 due to insurer exits from the market, a tenfold increase from historical averages, according to a study published Feb. 18 in JAMA. The…

Paul Markovich, president and CEO of Ascendiun, the parent company of Blue Shield of California, is not one to sugarcoat the state of the healthcare system. “I don’t see how you can look at it and say there isn’t a…

Centene has named Greg LaManna as its first chief duals integration officer under the company’s Medicare business, Wellcare. The company said Feb. 18 on Linkedin that the role was created to advance a more integrated and seamless experience for its…

The Alabama Senate unanimously passed a bill Feb. 17 that would allow the state’s dominant health insurer, Blue Cross Blue Shield of Alabama, to reorganize under a nonprofit holding company, a structure that would let the plan launch new subsidiaries…

Almost 35.5 million people were enrolled in a Medicare Advantage plan as of Feb. 1, up about 3% from 34.4 million at the same time last year, according to CMS data analyzed by Becker’s. Growth during the annual enrollment period…

Oklahoma will transition away from the federal ACA marketplace platform and launch a state-based exchange for 2028 coverage. Currently, 20 states and Washington, D.C. operate state-based exchanges, according to CMS. Oklahoma residents will continue to use HealthCare.gov to enroll in…

Humana’s healthcare services division CenterWell has completed its acquisition of MaxHealth, a Tampa, Fla.-based primary care network focused on adults and seniors, the company said Feb. 13. MaxHealth operates 54 primary care clinics, four specialty/ancillary clinics and 24 affiliated clinics…

Independence Blue Cross (IBX) is rolling out a severity-based payment approach for emergency inpatient admissions under Medicare Advantage, following a similar policy from Aetna that took effect earlier this year. Under the new policy, effective March 5, IBX will use…