Payer

Some insurers are sounding the alarm that Medicare coverage of weight loss drugs could increase premiums. 

Highmark Health reported $22.1 billion in revenue and $529 million in net income in the first nine months of 2024.

UnitedHealthcare has prevailed in its lawsuit against CMS regarding the methodology used to calculate its 2025 Medicare Advantage star ratings. 

Untreated mental health conditions often prevent people from seeking medical care, leading to more expensive emergency treatments. Personalized, targeted outreach based on AI-enabled insights can help address this problem.

States spend nearly $40 billion annually on expanded Medicaid coverage under the ACA, according to KFF.

Employer-sponsored insurance costs rose about 5% in 2024, driven in part by coverage of expensive weight loss medications, according to Mercer's National Survey of Employer-Sponsored Health Plans.

Most Medicare Advantage markets are highly concentrated, but in a handful of markets, one payer controls more than 70% of the MA landscape, according to the American Medical Association's annual Competition in Health Insurance report. 

The average Medicare beneficiary will have 34 Medicare Advantage plans available to them in 2025, with Pennsylvania being the highest at 71 plans, according to KFF.

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

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…