Premiums climb and profits hold steady as payers brace for 2026 shifts October 21, 2025 Want to talk business strategy with health plan peers who get it? Join Becker’s Payer Leadership Virtual Community — a private, off-the-record digital forum for…
Payer Issues
Pharmacy and plan shakeups — from Cigna’s TrumpRx deal to California’s crackdown on fake coverage October 20, 2025 1. Best Medicare Advantage carriers for 2026: US News Full story 2. Cigna, CVS partner with TrumpRx to offer fertility drugs Full story…
Layoffs, leadership changes and Medicare confusion — payers navigate open enrollment October 16, 2025 1. Blue Shield of California to conduct third round of layoffs Full story 2. CMS walks back Medicare payment pause Full story 3. Old workflows, new…
Medicare open enrollment, Humana’s stars lawsuit rebuffed, and telehealth pay issues October 15, 2025 1. Medicare open enrollment begins: 6 notes Full story 2. Judge rebuffs Humana's renewed star-ratings suit Full story 3. Watch our expert webinar Maximize Your ROI…
Network directory settlement, GLP-1 effects, and ongoing payer-provider tensions October 14, 2025 1. California settles network directory lawsuit with Centene for over $40M Full story 2. Covering GLP-1s could raise premiums by 14%: Study Full story 3. 3 genAI use…
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MA star ratings, PBM reform and mental health gaps — key payer updates this week October 13, 2025 1. Eighteen 5-star Medicare Advantage plans Full story 2. 23 Medicare Advantage plans rated below 3 stars Full story 3. GLP-1s alone aren't…
Star ratings, AI rules and ICHRA bills — major payer moves and state actions October 10, 2025 1. CMS posts 2026 Medicare Advantage star ratings: 8 notes Full story 2. Optum to buy Massachusetts medical group Full story 3. BCBS…
Insurers see shifts — from BCBS buyouts to new limits on private equity October 9, 2025 1. BCBS Massachusetts offers buyouts to 18% of workforce Full story 2. Judge dismisses Indiana Medicaid fraud case against Elevance, Centene, CareSource Full story…
October 8, 2025 1. California bill eliminating 'redundant' prior authorization barriers signed into law Full story 2. Why personal relationships among executives matter in payer-provider contract negotiations Full story 3. The 5 AI disruptors every healthcare exec should know: here. 4.…
October 7, 2025 1. UnitedHealthcare calls out healthcare groups' 'cynical' contract negotiation strategy Full story 2. 7 insurers fully exiting Medicare Advantage Full story 3. Navigating Payer Compliance with CERIS’s Cereasa Horner — insights on AI, oversight challenges, and strategies to stay…