Author: Rylee Wilson

Medicare Advantage insurers and brokers are facing a sweeping lawsuit from the Justice Department, and rising costs continue to hurt payers’ finances.  Here are eight Medicare Advantage updates to know: 

Blue Cross Blue Shield of Vermont is taking steps to shore up its finances in the face of unprecedented challenges, VTDigger reported May 7.  In July 2024, BCBS Vermont said it was in a “fragile financial state,” in the face…

A group of Democratic lawmakers is urging Republicans to turn their attention toward Medicare Advantage to cut healthcare spending.  In a letter to Senate Majority Leader John Thune and House Speaker Mike Johnson, 36 members of Congress urged leaders to…

Aetna’s exit from the individual market is both “sad” and an “opportunity” for Oscar Health, CEO Mark Bertolini told investors.  In May, Aetna said it would exit the individual exchange at the end of 2025. The exit will leave around…

Insurers are employing different strategies to manage the high cost of GLP-1 drugs.  In May, CVS Health announced a partnership with Wegovy manufacturer Novo Nordisk. CVS Caremark will use Wegovy as the preferred GLP-1 medication for its largest commercial formulary.…

Oscar Health’s individual exchange membership grew 45% year over year.  The insurer reported its first-quarter 2025 earnings May 7. The company posted $275.2 million in net income in the first quarter, up 55% from the same time last year.  Here…

Healthcare costs keep rising, and employers are looking for new ways to manage their employees’ care.  In a survey published by Imagine360, more than a third of respondents said they had skipped or postponed necessary healthcare because of the cost. …

Arizona has awarded Medicaid long-term care contracts to four managed plans after a yearlong dispute process.  UnitedHealthcare, Centene, Banner-University Care Advantage and Mercy Care will manage the Arizona Long Term Care System-Elderly and/or Physically Disabled program, according to a May…

The Cigna Group will introduce two new programs to help manage the cost and delivery of GLP-1 drugs.  On a May 2 earnings call, Cigna Group President and COO Brian Evanko, in addition to reporting total year-over-year revenue up 14%,…

At least eight health systems are getting out of the insurance business.