Payer

Profits were down year over year for half of the country's largest payers in 2021, but didn't stop double-digit growth for others. 

Six payers dominate the health insurance landscape in the United States, but each has taken dramatically different paths that define their approaches to the industry today. 

Payers, including Blue Shield of California, have been strong-armed to contract with the entire Sutter Health hospital system instead of being able to pick specific facilities to bring into their networks, according to Law360. 

California is reforming its Medicaid program, Medi-Cal, to address social determinants of health — a move that shifts state-sponsored health coverage toward whole-person health, according to CalMatters. 

Excellus BlueCross BlueShield is distributing $30 million across 31 New York providers to invest in quality improvements, according to a news release shared with Becker's. 

Payers' medical benefits ratios — the percentage of premium revenue spent on medical services — have fluctuated with the flow of the COVID-19 pandemic, resulting in industrywide increases.

Payers have been calling the Medicare Advantage market a competitive, but highly-desirable one. 

Mothers have increasingly opted to give birth in their homes during the COVID-19 pandemic, but insurers are largely refusing to cover them, according to a Feb. 11 report from Time. 

A lawsuit filed Feb. 9 in Connecticut accuses Aetna of discriminating against homosexual women through its fertility treatment coverage policies, according to Top Class Actions. 

Anthem topped the list of payers by total membership, while Aetna saw the smallest growth in 2021.