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Robert Andrews — a former congressman and the CEO of the Health Transformation Alliance, a cooperative of self-insured companies — predicts AI will be able to personalize formularies for patients within five years. “Formularies are really built upon economic, commercial…

The California Department of Managed Health Care has issued a cease-and-desist order against Meritage Health Plan, effectively shutting down the Medicare Advantage insurer by the end of October.  The Aug. 27 order requires six health plans (Alignment Health, Humana, SCAN…

A group of Republican lawmakers is pressing the Trump administration to step up enforcement of the No Surprises Act, citing ongoing problems with implementation and the IDR process. “We request the departments finalize clear and consistent QPA calculation methodology, accelerate…

Employers are gravitating toward “transparent” pharmacy benefit managers this year, according to a survey from the National Alliance of Healthcare Purchaser Coalitions.  The 2025 “Pulse of the Purchaser” survey collated responses from purchasers and employers across the country. With nearly…

Seven U.S.-based health payers made Time and Statista’s 2025 list of the world’s top 1,000 companies. Time and market research firm Statista compiled the ranking by evaluating employee satisfaction, revenue growth and sustainability transparency. Cigna ranked 10th overall — jumping…

UnitedHealth Group has boosted lobbying efforts and executives have met with several Trump administration officials this year amid ongoing federal investigations and reimbursement changes that have negatively impacted profits, The Wall Street Journal reported Sept. 14. Since May, UnitedHealth leadership,…

Discharge decisions may contribute to the significant healthcare challenges associated with sepsis. Though sepsis patients are often discharged to skilled nursing facilities (SNFs), data demonstrates that transitioning patients to long-term acute care hospitals (LTACHs), which provide continued acute care for…