Payer

Primary care accounts for more than 35% of U.S. healthcare visits, but only 5% of healthcare spending. To address this gap, a California agency has set a goal for insurers in the state to direct 15% of their spending to primary…

The vast majority of Medicare Advantage markets are highly concentrated, according to the American Medical Association's annual Competition in Health Insurance report. 

Almost half of the nation's local commercial insurance markets are majority controlled by one payer, according to the American Medical Association.

Prospective CMS Administrator Mehmet Oz, MD, has been a major proponent of Medicare Advantage, and has pitched expanding the program to extend coverage to all Americans. 

Healthcare logistics company Owens & Minor has filed a lawsuit against Anthem Blue Cross and Blue Shield of Virginia, accusing the insurer of failing to uphold its fiduciary duties under ERISA through mismanagement of its employee health plan. 

From the Justice Department suing to stop its acquisition of a home health company to naming a new chief information security officer, here are 12 updates on UnitedHealth Group and its subsidiaries that Becker's has reported since Nov. 1: 

Almost half of the nation's local commercial insurance markets are majority controlled by one payer, according to the American Medical Association.

UnitedHealthcare alleges CMS treated its Medicare Advantage star ratings differently compared to Elevance Health, according to court documents unsealed Nov. 18. 

Medicare Advantage plans faced several headwinds in 2024, including rising medical costs, declining star ratings and a tougher reimbursement environment. 

Molina Healthcare is partnering with Instacart in Michigan to address food insecurity among expectant mothers.