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…
Author: Jakob Emerson
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…
The California Public Employees’ Retirement System is accusing UnitedHealth Group of securities fraud related to its Medicare Advantage billing practices. The class action, first filed in May 2024 and amended March 21, alleges that UnitedHealth misled investors about its operations,…
The Tennessee Supreme Court has ruled in favor of BlueCross BlueShield of Tennessee in a case involving the termination of an employee who emailed state legislators opposing the company’s COVID-19 vaccine mandate. On March 26, the court reversed a lower…
I. Introduction Payer-led care management serves as an important mechanism through which payers can exert influence on health outcomes, close care gaps, and enhance the performance metrics of health plans. It is progressively becoming more important in the rapidly evolving…
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The average deductible for a Medicare Advantage plan more than doubled to $315 from 2024 to 2025, according to a March 26 survey from online broker eHealth. eHealth’s new analysis examined costs and plan selection trends for more than 250,000…
A federal judge in Minnesota has dismissed a proposed class-action lawsuit against Wells Fargo, which alleged the company mismanaged its employee health plan, resulting in inflated prescription drug costs for its employees. Originally filed in July 2024, the lawsuit accused…
Moody’s has downgraded Health Care Service Corporation’s insurance financial strength rating to A3 from A2 following the company’s acquisition of Cigna’s Medicare business on March 19. Moody’s cited likely challenges with the integration of the MA business into the company’s…
Kaiser Permanente and UnitedHealthcare have tied as the best U.S. health insurance companies in 2025, according to Insure.com’s annual ranking. In the final 1 through 5 score, 60 percent came from member survey results, 25 percent from NCQA member satisfaction…
A new report analyzing healthcare spending trends within New York City’s employee health plan says there are significant gaps in data because Anthem Blue Cross reportedly refused to release complete pricing information. New York City spends more than $11 billion…