Payer

Highmark Health Plans reported $6.1 billion in operating revenue and a $9 million operating loss in the first quarter of 2025, citing elevated utilization and continued industrywide pressures that carried over from last year. Parent company Highmark Health reported $8…

As healthcare becomes increasingly data-driven, payers are turning to clinical health record data to strengthen claims processing, care coordination and risk management. This shift reflects a broader industry trend toward more integrated, real-time data use across the care continuum. With…

Blue Cross Blue Shield of Minnesota and Blue Cross Blue Shield of North Dakota are the first two insurers to earn URAC’s Mental Health/Substance Use Disorder Parity Accreditation.  The certification is the only program of its kind in the U.S.,…

Walmart is launching new digital offerings that will integrate with Medicare Advantage supplement plans. Members will be able to choose from plan-specific, benefits-eligible products while shopping online for same-day pickup or delivery in as soon as an hour, according to…

The gaps between the highest and lowest rated commercial health plans for customer satisfaction are growing, according to J.D. Power’s U.S. Commercial Member Health Plan Study.  J.D. Power published its annual ranking of the top commercial health plan in each…

An investor-led lawsuit has been dropped against UnitedHealth Group, its former CEO Andrew Witty, and CFO John Rex, which alleged the company misled investors about its corporate strategy in the aftermath of the December killing of UnitedHealthcare CEO Brian Thompson. …

States that extend Medicaid coverage to individuals without legal status will receive fewer federal Medicaid dollars if budget legislation passed by the House of Representatives is finalized, according to KFF.  The legislation would reduce federal Medicaid funding matches to 80%…

Anthem Blue Cross of California has expanded its behavioral health network by 10,000 providers in the past two years.  The insurer has grown its behavioral health offerings by 90% since 2020, according to a May 27 news release shared with…

Use of the Collaborative Care Model for integrated mental healthcare has risen dramatically across Medicare, Medicaid and the commercial market since 2018, according to a report from consulting firm Milliman.  The Collaborative Care Model was developed in the 1990s, but…

CVS Health has grown from a single store to a healthcare giant, operating pharmacies, a major insurer and primary and home care clinics.