Blue Cross and Blue Shield of Kansas City (Mo.) and Highmark, both nonprofit independent licensees of Blue Cross Blue Shield, are planning to affiliate, according to a Dec. 11 news release. Blue KC will retain its local leadership and headquarters…
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Insurers are publishing incomplete price transparency data, with hospital inpatient information particularly sparse, according to a study published in the American Journal of Managed Care in December. Researchers from Simple Healthcare analyzed 2025 Transparency in Coverage files from Aetna, Cigna,…
Average worker contributions toward family insurance premiums grew by 308% between 1999 and 2024, according to a Dec. 8 research letter published in JAMA Network Open. Researchers from Rice University and Baylor College of Medicine, both based in Houston, found…
Traditional Medicare could have saved $7 billion from 2019 to 2023 across four services had it mirrored Medicare Advantage’s utilization rates and fraud strategies, according to a December Berkeley Research Group report sponsored by Elevance Health. Because MA plans are…
Denials are rising. Work is piling up. And hiring more staff isn’t a sustainable solution. For today’s revenue leaders, small optimizations aren’t enough. It takes a new model — one where AI agents, robots and staff operate in sync to…
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UnitedHealth Group continues to be the largest health insurer in the U.S., with nearly 45 million members in 2025, according to the Peterson-KFF health system tracker. The data is from Mark Farrah Associates and includes enrollment across the individual market,…
Health plans are facing rising claim volumes, staffing challenges, and a surge in rework. Traditional automation, tied to individual applications, can’t keep up. Agentic automation offers a better way. By unifying AI agents, software robots and humans in a coordinated…
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Amy Schulman will join Elevance Health’s board as an independent director Jan. 12, 2026, according to a Dec. 10 news release. She will serve on the audit and finance committees. Ms. Schulman is currently a managing partner at the venture…
CMS’s proposed Medicare Advantage rule for 2027 includes more leeway for hemp coverage. Hemp has low concentrations of tetrahydrocannabinol, as defined by the Agriculture Improvement Act of 2018. Under the proposal, hulled hemp seed, hemp seed protein powder and hemp…
Highmark recently shared how it increased generic and biosimilar access to members, focusing on drugs for multiple sclerosis, cancer and autoimmune conditions. The insurer has been working with CivicaScript, a nonprofit generic drug company it helped found, to offer these…