Payer

In 2024, Inland Empire Health Plan achieved significant growth through the expansion of healthcare facilities, recognition on top industry rankings, strengthened partnerships with local and community organizations, and an expanded product portfolio, according to the organization's 2025 Annual Quality Report.

In 2025, health insurance leaders are focused on leveraging technology, particularly AI, to enhance healthcare delivery, expand access, address system complexities, and advance value-based care, while expanding their footprints to improve member experience and streamline operations.

A Texas lawmaker has introduced a bill that would prohibit payers from using artificial intelligence to delay, deny or modify claims, NBC affiliate KXAN reported Jan. 21. 

Ten providers recently posted job listings seeking leaders in payer contracting and relations.

Federal regulators questioned $8.47 million in charges from Florida Blue and its administration of the Federal Employees Health Benefits Program from 2018 to 2023.

Payers are making strides in addressing disparities around mental health and substance use disorder care services but are still falling short of achieving parity under the Mental Health Parity and Addiction Equity Act, according to a Jan. 17 report to…

CMS issued nearly $2.5 million in fines on Jan. 17 across multiple health plans for Medicare contract violations related to Part C maximum out-of-pocket limits and cost-sharing requirements, and Part D coordination of benefits and low-income subsidy requirements.

The medical cost challenges that have challenged insurers in 2024 will not be going away in 2025, UnitedHealth Group executives said. 

Though Medicare Advantage beneficiaries are more likely to have coverage of vision, dental and hearing services, they are not more likely to use these services than their peers in traditional Medicare, a study published Jan. 14 in JAMA Network Open…

Optum Rx will pass 100% of the rebates it negotiates for drugs onto its consumers by the end of 2028, UnitedHealth Group CEO Andrew Witty told investors.