Peak Health is planning its largest expansion to date in the Medicare Advantage market, more than doubling its potential footprint in its home state and moving into Pennsylvania for the first time. “We’re looking to expand substantially. We will be…
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Blue Cross and Blue Shield of Massachusetts reported a net loss of $129.7 million on revenue of $2.6 billion (-4.9% net margin) in the second quarter. Year-to-date, the company has reported a net loss of $92.6 million on revenue of…
Georgia regulators are fining health insurers more than $20 million for failing to comply with state and federal mental health parity laws. Insurance Commissioner John King said Aug. 15 that the penalties follow examinations that uncovered more than 6,000 violations…
With recent breakthroughs in artificial intelligence (AI), health plans are at a precipice of change. At Optum, we’re leveraging emerging technologies to drive payment accuracy—but it’s just the starting point. We believe AI has the potential to completely transform the…
Mountain Health Co-Op, which insures more than 11,000 people in Wyoming, is exiting the state at the end of 2025, Cowboy State Daily reported Aug. 14. Mountain Health CEO Blair Fjeseth told the news outlet that several factors contributed to…
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CMS has lifted an enrollment suspension on Wellcare of Missouri’s Medicare Advantage prescription drug plan, effective Jan. 1, 2026. The sanction was originally imposed Sept. 6, 2024, after Wellcare failed to meet the federal minimum medical loss ratio of 85%…
Medicare Advantage enrollment in rural America has quadrupled since 2010, reaching 40% of eligible beneficiaries in 2023, but still far below the 53% penetration in metropolitan areas. Rural beneficiaries now have an average of 27 MA plans to choose from,…
Employers are expecting a median healthcare cost increase of 10% in 2026, according to a survey from the International Foundation of Employee Benefit Plans. The results reflect the responses from 150 corporate and single employers surveyed between July 30 and…
Humana and DrFirst are launching a new program aimed at closing care gaps among patients with chronic health conditions such as diabetes and cardiovascular disease. The first phase of the program will look to increase the use of statin therapy…
The coming year is expected to be an even more “intense and disruptive” period for Medicare Advantage, as rising utilization, pharmacy costs and shifting market dynamics put new pressure on plans, while also creating opportunities for provider-sponsored models. Becker’s connected…