Payer

UnitedHealth Group has spent much of 2024 dealing with the fallout from the Change Healthcare attack. 

As large national Medicare Advantage carriers face financial headwinds and tensions with health systems, one New York payer says business in the market is booming. 

Making expanded ACA subsidies permanent would add $335 billion to the national deficit between 2025 and 2034, the Congressional Budget Office estimated. 

Some Blue Cross Blue Shield companies say weight loss drugs have played a part in recent financial challenges, and one plan has made the decision to roll back benefits.

CMS will put $500 million over the next five years toward navigators designed to help people navigate the ACA exchange, the largest investment in the program to date. 

The U.S. Supreme Court has declined to hear Home Depot's challenge to a $2.67 billion settlement with Blue Cross Blue Shield companies, ending a legal saga over alleged anticompetitive behavior that dates back to 2012.

Blue Shield of California has fired a top executive for allegedly lying about her medical credentials, a spokesperson for the company told Becker's.

Some of the nation's largest health insurers have signaled significant headwinds in recent months within their Medicaid businesses as costs rise and the effect of redeterminations takes hold, but Fitch analysts expect those headwinds to be short-lived.

The majority of state Medicaid directors want to keep some of the temporary flexibilities CMS introduced during the redeterminations process, according to KFF. 

CMS will recalculate Medicare Advantage plans' 2024 star ratings, which could net some insurers millions more in bonus payments.