Optum has launched Value Connect, an AI-powered platform designed to help payers and providers operationalize value-based care models by combining clinical, operational and financial data into a single system. The platform uses AI across quality measures, utilization patterns and risk…
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One in 10 Medicare Advantage enrollees were forced to disenroll from their health plan heading into 2026 due to insurer exits from the market, a tenfold increase from historical averages, according to a study published Feb. 18 in JAMA. The…
BCBS Michigan saved $67 million and $80 million in 2024 and 2025, respectively, through biosimilar use, the insurer reported Feb. 17. The company began moving members from Humira and Stelara to alternatives like Simlandi and Yesintek in 2025. Currently, 99%…
The Indiana Hospital Association is aiming to “expose abusive insurer practices” through its Access Denied campaign, a Feb. 17 news release said. The initiative includes a web portal addressing care denials, amplifies media coverage of denials and prompts people to…
Minnesota’s ACA exchange, MNsure, saw an 8% drop in private health insurance enrollment this year, according to a Feb. 10 news release. When the annual enrollment period ended Jan. 15, 139,251 Minnesotans had 2026 coverage through the exchange, versus 151,512…
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Imagine360’s new chief product officer, Nilima Rajkumar, has concerns with pricing transparency in healthcare, specifically how traditional insurers may go off of hospitals’ chargemasters. “[Insurers] are offering you a discount, but it’s like, a discount off of what?” she said…
Almost 35.5 million people were enrolled in a Medicare Advantage plan as of Feb. 1, up about 3% from 34.4 million at the same time last year, according to CMS data analyzed by Becker’s. Growth during the annual enrollment period…
Oklahoma will transition away from the federal ACA marketplace platform and launch a state-based exchange for 2028 coverage. Currently, 20 states and Washington, D.C. operate state-based exchanges, according to CMS. Oklahoma residents will continue to use HealthCare.gov to enroll in…
AmeriHealth Caritas is dropping its pharmacy benefit manager business, PerformRx, and transitioning to Optum Rx instead, the insurer confirmed to Becker’s Feb. 17. AmeriHealth Caritas is moving away “after a multiyear review” of PBM options. PerformRx will wrap operations “in…
In a Feb. 11 budget proposal, Gov. Gretchen Whitmer laid out how she plans to secure $780.4 million to stabilize Medicaid. Ms. Whitmer is aiming to bring in $232 million from tobacco, $73.6 million from vaping and non-tobacco nicotine products,…