Payer

For the third year in a row, Colorado lawmakers have advanced a bill that would explore the feasibility of a statewide universal healthcare payment system. 

KLAS Research, a healthcare IT data and insights company, named its "Best in KLAS" payer tools for 2025.

Prior authorization reforms remain a major advocacy priority for provider trade groups in 2025, and several state lawmakers have also introduced legislation to bring changes to the process.

The largest Medicaid managed care provider in the U.S. is declaring the redeterminations era over. 

Cigna has agreed to pay $2.9 million to settle a class-action lawsuit alleging it failed to reimburse members for COVID-19 testing.

Centene lost nearly 1.5 million Medicaid members in 2024, but posted 12% enrollment growth in its marketplace segment, according to the company's fourth quarter earnings report published Feb. 4

Moody's has revised its outlook for the health insurance sector to negative, citing continually high medical costs that are expected to constrain earnings growth in 2025. 

The Cigna Group will tie executive pay to customer satisfaction as part of an initiative to improve members' experiences. 

Salt Lake City-based Intermountain Health, through its insurance arm Select Health, rebranded its pharmacy benefit manager to Scripius, a move that highlights the growing trend of health systems bringing PBMs in-house. 

In January, some Blue Cross Blue Shield companies planned layoffs and buyouts to combat rising costs.