The American College of Physicians published recommendations for managed care Nov. 25 in the group’s flagship journal, Annals of Internal Medicine. Managed care plans, like HMOs and PPOs, are insurance models that focus on mitigating costs and utilization while maintaining…
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The Illinois Department of Healthcare and Family Services launched home-visit coverage for pregnant and parenting Medicaid enrollees, effective Nov. 21. Under the initiative, the state covers some prenatal visits, including sessions for health education, blood pressure monitoring, behavioral health screenings,…
HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas. The 2023 final rule allowed CMS…
UnitedHealth Group has purchased a four-story, 79,000 square foot medical office building in Henderson, Nevada. The $46.1 million building houses Optum Nevada’s new Cactus Healthcare Center and marks the largest medical office transaction in the Las Vegas market this year,…
Payers have faced state penalties in 2025 for slow reimbursements, improper claims denials, and mental health parity violations. Fines in 2024 are here. Payers fined by states in 2025:
“Affiliation” is a buzzword in insurer partnerships. It may seem ambiguous, but this is a standard term for nonprofit M&A-type activity. A CareSource spokesperson told Becker’s that the nonprofit does not always use the term “acquisition,” instead calling an agreement…
Vermont will have the highest average monthly premiums for the lowest-cost Gold-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $615. Premiums were analyzed using the lowest-cost premium for a 40-year-old…
Vermont will have the highest average monthly premiums for the lowest-cost Bronze-tier marketplace plan in 2026, while Maryland will have the lowest, according to KFF. The national average is $456. Premiums were analyzed using the lowest-cost premium for a 40-year-old…
A Medicare tool for adjusting risk underpredicts mortality and overpredicts spending for rural beneficiaries, according to research from the Philadelphia-based Leonard Davis Institute of Health Economics at the University of Pennsylvania. The study, published in the September 2025 issue of…
Blue Cross and Blue Shield of Minnesota will no longer offer gym memberships for Medicare beneficiaries at YMCA of the North and at Life Time, as of Jan. 1, both gym operators and the insurer confirmed to Becker’s. About 26,000…