Massachusetts’ Division of Insurance and Department of Public Health has issued a bulletin Sept. 3 requiring insurance carriers to cover vaccines as outlined by the state, not just the CDC. “We won’t let Donald Trump and Robert Kennedy get between…
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UCare has asked CMS to mutually terminate its Medicare Advantage plans for 2026, citing rising medical costs and challenges within the broader market. “This decision was not made lightly,” President and CEO Hilary Marden-Resnik said Sept. 4 “UCare remains deeply…
The House Committee on Oversight and Government Reform is investigating CVS Health over reports of the company using confidential patient information to lobby against a bill under consideration by the Louisiana legislature. Chairman James Comer, R-Ky., and Subcommittee on Federal…
Samaritan Health Plans, the insurance arm of Corvallis, Ore.-based Samaritan Health Services, will exit the Medicare Advantage market in 2026, the Lincoln Chronicle reported Sept. 3. Bruce Butler, CEO of Samaritan Health Plans, told Becker’s in a statement that the…
Portland-based CareOregon has hired McKinsey & Co. as the nonprofit insurer navigates financial challenges, Willamette Week reported Sept. 3. CareOregon laid off 80 employees and canceled 70 empty roles in July. In a statement shared with Becker’s, CareOregon cited rising…
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Total health benefit costs per employee are slated to increase 6.5% in 2026, marking the highest jump since 2010, according to Mercer’s 2025 National Survey of Employer-Sponsored Health Plans. That figure takes cost-reduction measures into account. Employers estimate nearly a…
A group representing nonprofit health plans is raising concerns over what it claims is a wide variation in Medicare Advantage risk adjustment scores across insurers, leading to what it calls a “gaming” of MA payments to the benefit of for-profit…
Executive Summary Payer-provider contracts are the backbone of financial and operational efficiency in the U.S. healthcare ecosystem. Seemingly straightforward, a payer-provider contract is the legal agreement between a healthcare payer and a provider that outlines the terms for delivering and…
Aledade’s ACOs accumulated $1 billion in savings through the Medicare Shared Savings Program in 2024. The network of independent primary care providers worked with about 11% of all MSSP beneficiaries, contributing nearly 20% of the program’s shared savings, according to…
SCAN Health Plan is expanding into Washington state and will enter new counties in California and Texas. Pending CMS approval, the nonprofit insurer will offer plans in Pierce, Spokane, and Thurston counties in Washington; Sacramento, Placer, Yolo, San Joaquin, Kings,…