September 9, 2025 1. 'Denial is not a strategy in 2025': Why this payer is calling the insurance industry broken Full story 2. UnitedHealthcare expects most Medicare Advantage members to be in 4+ star plans in 2026 Full story 3.…
Payer Issues
September 8, 2025 1. Hospitals aren't the only ones stepping back from Medicare Advantage Full story 2. BCBS Tennessee cuts more jobs Full story 3. Healthcare needs AI that delivers. The 5 companies making it happen: here. 4. Aetna, Optum…
September 5, 2025 1. Elevance among latest insurers to pull back on Medicare Advantage Full story 2. GOP lawmakers file bill to extend enhanced ACA subsidies Full story 3. From GLP-1 costs to chronic care ROI: Hear what payer CFOs…
September 4, 2025 1. Medicare Advantage risk adjustment 'a failing system': Report Full story 2. CMS expands eligibility for catastrophic health plans Full story 3. Pressure to eliminate ghost networks is rising. See how payers are responding: here. 4. Florida Blue,…
September 3, 2025 1. UnitedHealthcare grows gold card program Full story 2. Biggest health plan wins in 2025 from 5 leaders Full story 3. Turn disconnected data into actionable intelligence. Get an inside look at BCBS plans' member-first strategies here.…
September 2, 2025 1. Cigna invests $3.5B in former Walgreens specialty pharmacy subsidiary Full story 2. Medicare Advantage plans keep senior care costs down in California: UCLA study Full story 3. BCBS leaders: Streamline prior auth with AI-powered data strategies.…
August 29, 2025 1. UnitedHealthcare sues Radiology Partners over No Surprises claims Full story 2. Medical associations push back on Cigna's new downcoding policy Full story 3. AI is moving payment integrity from automation to transformation—see how it’s reshaping accuracy…
August 28, 2025 1. No Surprises dispute process has cost $5B since 2022: Study Full story 2. Aetna expanding claims reviews in September Full story 3. BCBS leaders: Streamline prior auth with AI-powered data strategies. Details here. 4. New York…
August 27, 2025 1. UnitedHealth criminal probe goes beyond Medicare: Report Full story 2. Blue Shield of California taps CEO Full story 3. Policy shifts are hitting benefits and budgets. Find Cigna's breakdown for execs here. 4. 5 Massachusetts insurers…
August 26, 2025 1. Johns Hopkins goes out of network with UnitedHealthcare Full story 2. Payer mix in the largest for-profit health systems Full story 3. AI is moving payment integrity from automation to transformation—see how it’s reshaping accuracy and…
