Payer

Alignment Healthcare's overall losses are continuing to improve as the Medicare Advantage provider adds members and offerings. 

Centene has donated to political candidates in states where it is up for Medicaid contract selection or defending itself against overbilling accusations, sometimes through multiple subsidiaries, according to a Kaiser Health News report published Nov. 4. 

Senate Finance Committee Democrats are pushing for tighter regulation of Medicare Advantage marketing from CMS and Congress. 

More than 1 in 3 beneficiaries transition insurance 12 months before or after giving birth, a study published in JAMA Network Open Nov. 3 found. 

Around half of payers had a data breach incident over the past five years, a report from LexisNexis Risk Solutions found. 

UnitedHealth Group was the largest health insurer by national-level market share in 2021, according to a Nov. 1 analysis from the American Medical Association. 

In late October, Pennsylvania state lawmakers sent a bill aiming to streamline the prior authorization process to the governor's desk, making it one of several states that have taken steps to reform that process this year. 

With most healthcare organizations having now released their third quarter earnings, the gap between provider and payer profits continues to widen.

Alabama has the most concentrated commercial health insurance market in the U.S., making it the state with the least competitive market, according to a Nov. 1 analysis from the American Medical Association. 

Cigna raised its annual earnings outlook and reported a 70 percent boost in third quarter profits compared to the same period last year, according to the company's earnings report published Nov. 3.