Payer

For health plans, the numbers are sobering: rising medical loss ratios, escalating healthcare costs, and increasingly complex patient needs are straining resources across the industry. Yet within this challenging landscape lies an overlooked opportunity for transformation: medication optimization.

Blue Cross Blue Shield of Massachusetts reported a $400 million operating loss in 2024, driven by spending on GLP-1 medications and other rising medical costs. 

Elevance Health and Centene saw their Medicaid memberships decline by more than 20% through the redeterminations process. 

The New Hampshire Insurance Department has issued an order requiring Aetna to prove why it should not be fined or have its operating license suspended in the state. 

Blue Cross Blue Shield of Michigan had more than 750,000 members across its Medicare Advantage plans in 2025, according to CMS data published Feb. 25. 

Here are 10 updates on UnitedHealth Group and its subsidiaries that Becker's has reported on since Feb. 6: 

Aetna, Blue Shield of California, and Centene's Health Net are teaming up on a new, shared payment model for primary care physicians in California. 

The behavioral health crisis in America continues to escalate. With mental health conditions affecting one in five adults and contributing to over $200 billion in annual healthcare spending, traditional fee-for-service models are inadequate to address this growing challenge.

UnitedHealthcare added more than 400,000 Medicare Advantage members during the annual open enrollment period, according to data CMS published Feb. 25.  

SCAN Group will launch a new member portal and app before the end of summer, aiming to tackle key member pain points through personalization, improved care access, and self-service tools.