Matt Hocks is taking over managing Sanford Health Plan and Security Health Plan, according to a Jan. 7 news release. Mr. Hocks, executive vice president and COO of Sioux Falls, S.D.-based Sanford Health, joined the system in 2004. He worked…
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CMS estimated there were $28.83 billion in improper payments for Medicare fee for service in fiscal 2025. Compared to 2024 reporting, that value is down from $31.7 billion. “While CMS’ improper payment reporting programs are designed to protect the integrity…
The Missouri attorney general’s office has filed a lawsuit against 19 pharmacy benefit managers and drug manufacturers, alleging they conspired to inflate insulin prices and deceive consumers. The lawsuit claims the defendants engaged in deceptive and unfair practices that caused…
Bloomington, Minn.-based HealthPartners launched its copay-only health plan, Simplica NextGen Copay, this year. The plan sets prices for in-network care without a deductible or coinsurance. Moe Suleiman, senior vice president of commercial business, and Maggie Helms, senior vice president, chief…
New Mexico has seen the biggest increase in ACA enrollment from 2025 to 2026, while North Carolina has seen the largest decrease, according to KFF. The ranking below uses preliminary CMS data comparing similar periods during the 2025 and 2026…
As Blue Cross Blue Shield licensee Hawaii Medical Service Association and Honolulu-based Hawaii Pacific Health prepare to form One Health Hawaii, they are going under the microscope. A Jan. 13 informational briefing run by Hawaii’s House and Senate committees on…
Imagine AI tools that clinicians trust, workflows that actually improve care and governance that supports scale instead of slowing it down. For many health systems, the reality looks different. AI pilots stall. Clinicians push back. Value is hard to quantify.…
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Kaiser Permanente has named its Colorado market president, Mike Ramseier, as senior vice president of national health plan markets. Mr. Ramseier has been with Kaiser since 2019. Before that, he served in senior leadership positions at Beacon Health Options and…
Sustained GLP-1 use slows medical cost growth, according to findings published Jan. 13 from professional services firm Aon. The firm analyzed 192,000 GLP-1 users from July 2022 to March 2025, comparing outcomes to non-users, through commercial medical and pharmacy claims…
Salt Lake City-based University of Utah Health Plans has named Michael Hales CFO, effective Jan. 1. Mr. Hales will lead the financial, actuarial and Medicaid strategy for the health plan, while continuing in his current role as associate executive director…