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'A scary time right now': Inside UPMC's Medicaid contingency plan
In 2025, the Medicaid program is facing another period of uncertainty. -
Payers with the most active digital strategies
In 2024, health insurers made 482 updates to their public and members-only websites. -
UnitedHealth reports investor who suggested SEC investigate profits
UnitedHealth Group raised concerns with the SEC after hedge fund manager Bill Ackman suggested the company's profitability could be "massively overstated," Bloomberg reported Feb. 5. -
Elevance Health's food-as-medicine roadmap: 5 things to know
Elevance Health has more than 60 food-as-medicine programs across its health plans, according to a new report. -
'Single payer' bill advances in Colorado
For the third year in a row, Colorado lawmakers have advanced a bill that would explore the feasibility of a statewide universal healthcare payment system. -
The 10 best payer tools, per KLAS
KLAS Research, a healthcare IT data and insights company, named its "Best in KLAS" payer tools for 2025. -
The prior authorization reform push continues
Prior authorization reforms remain a major advocacy priority for provider trade groups in 2025, and several state lawmakers have also introduced legislation to bring changes to the process. -
The redeterminations 'era' is over: 5 notes on Centene's strategy
The largest Medicaid managed care provider in the U.S. is declaring the redeterminations era over. -
Cigna settles lawsuit over COVID-19 testing for $2.9M
Cigna has agreed to pay $2.9 million to settle a class-action lawsuit alleging it failed to reimburse members for COVID-19 testing. -
Centene posts $3.3B profit in 2024
Centene lost nearly 1.5 million Medicaid members in 2024, but posted 12% enrollment growth in its marketplace segment, according to the company's fourth quarter earnings report published Feb. 4 -
Moody's: Negative outlook for payers in 2025 amid rising costs
Moody's has revised its outlook for the health insurance sector to negative, citing continually high medical costs that are expected to constrain earnings growth in 2025. -
Cigna links executive pay to customer satisfaction: 5 notes
The Cigna Group will tie executive pay to customer satisfaction as part of an initiative to improve members' experiences. -
Behind Intermountain Health's in-house PBM
Salt Lake City-based Intermountain Health, through its insurance arm Select Health, rebranded its pharmacy benefit manager to Scripius, a move that highlights the growing trend of health systems bringing PBMs in-house. -
Executive moves, acquisitions and more: 13 BCBS updates
In January, some Blue Cross Blue Shield companies planned layoffs and buyouts to combat rising costs. -
Payer CEOs increased home security following UnitedHealthcare shooting: Report
Insurance CEOs hired police in multiple states to provide security and conduct checks at their homes following the fatal shooting of UnitedHealthcare CEO Brian Thompson in late 2024, the Washington Post reported Jan. 29 -
Cigna board authorizes 8% increase in quarterly dividend
Cigna's board of directors declared a $1.51 per share cash dividend to be paid March 20. -
Judge partially dismisses lawsuit accusing J&J of mismanaging employee drug benefits
A federal judge has partially dismissed a lawsuit filed by a former Johnson & Johnson employee alleging that the pharmaceutical giant mismanaged its employees’ prescription drug benefits, thereby violating its fiduciary duties under the Employee Retirement Income Security Act. -
Aetna, Centene, Blue Shield launch 'single payment' primary care model in California
Aetna, Blue Shield of California and Centene's Health Net have launched a shared, value-based payment model for reimbursing primary care physicians in California. -
Medicare Advantage insurers ranked by prior authorization denial rates | 2023
Centene and CVS Health had the highest rates of prior authorization denials in 2023, according to a report from KFF. -
Cigna posts $3.4 billion profit in 2024
The Cigna Group saw a 34% decline in profits year over year as the company faces rising costs within its insurance business, according to its fourth quarter earnings report published Jan. 30.
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