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AI could help hospitals lower costs, but Fitch said those savings could prompt payers and policymakers to reprice reimbursement. The…
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Tacoma, Wash.-based MultiCare Health System is launching a health insurance plan. MultiCare Health Plan, announced Oct. 1, will operate as a wholly owned subsidiary of the 13-hospital nonprofit system. Its first product is a Medicare Advantage HMO with prescription drug…
Cigna is launching a modernization and productivity initiative, expected to bring in $3 billion in savings by 2030. During the company’s Sept. 30 investor day call, CFO Ann Dennison said the multiyear program focuses on automating workflows, ensuring a future-ready…
The Medicare Advantage market remains a bit of a paradox: it may look unchanged from a national level heading into 2027, but seniors will have fewer plans to choose from in more than half of the states and growth continues…
A behavioral health crisis can happen to anyone. It occurs when emotional distress becomes overwhelming and a person may feel unable to cope, think clearly, stay safe, or function in daily life. Crises can involve severe anxiety, depression, thoughts of…
Twelve payers are exiting the Medicare Advantage market for 2027, according to CMS data. Eight of the twelve are owned entirely or in part by health systems. Several other payers will stay in MA next year only through special needs…
There will be four new entrants to the Medicare Advantage market in 2027, according to CMS data. In contrast, 12 payers that sold MA plans in 2026 won’t offer them next year, and the largest insurers collectively are pulling out…
While some payers are slimming down their Medicare Advantage reach, some are betting big on special needs plans. SNPs cover dually eligible Medicaid individuals (D-SNP), those with chronic conditions (C-SNP) and those needing long-term care (I-SNP). CMS released data Sept.…
CMS Administrator Mehmet Oz, MD, is urging employers to consider an alternative to traditional group health plans that allows workers to select their own individual insurance coverage. Speaking Sept. 30 at an event in Austin, Texas, Dr. Oz promoted CHOICE…
Dallas-based Baylor Scott & White Health reported operating income of $1.5 billion (8.3% margin) during the fiscal year ending June 30, 2026, down from a $1.7 billion operating gain (10% margin) in the previous fiscal year, according to financial statements…
Independence Blue Cross has agreed to pay $22.5 million to resolve allegations that it used inaccurate diagnosis codes to inflate its Medicare Advantage payments, according to a Sept. 30 Justice Department news release. The government alleged the insurer violated the…