Payer

For payers, drug formulary development and maintenance are essential for accurate reporting and tracking of prescription medications. An up-to-date and well-established classification resource can help payers and other stakeholders manage their drug formulary more efficiently. While several classification resources are…

The majority of health plan executives are focused on growth and have a favorable outlook for 2025, according to a Dec. 12 survey from the Deloitte Center for Health Solutions.

Humana welcomed a new CEO in 2024 amid rising Medicare Advantage costs.

Elevance Health added several acquisitions in 2024. 

The year 2024 proved to be a pivotal and tumultuous period for the health insurance industry, defined by the shocking murder of UnitedHealthcare's CEO and the largest cyberattack in the sector's history. Legal and regulatory battles over Medicare Advantage, significant…

HHS' Office of Inspector General estimated three Medicare Advantage insurers received around $11.4 million in overpayments. 

The year 2024 will be remembered as one full of unprecedented challenges and turmoil for the nation's largest healthcare company. 

While most Medicare Advantage plans offer dental benefits, few of these benefits are comprehensive, a study published Dec. 26 in JAMA found. 

An insurer reached a nearly $100 million settlement over allegations of overpayments, and CMS plans to sunset a value-based model over "unprecedented" costs. 

UnitedHealth Group has optimized its ability to increase Medicare Advantage members' sickness scores and corresponding government payments by directly employing thousands of physicians at Optum and integrating sophisticated software tools into clinical workflows, according to a Dec. 29 investigation from…