Payer

Medicare Advantage enrollees spend more than $2,500 less on healthcare costs on average than traditional Medicare enrollees, according to an independent analysis by ATI Advisory.

Humana's challenge to a CMS rule implementing stricter auditing standards on Medicare Advantage plans can continue, a federal judge ruled. 

Courts sided with SCAN Health Plan in a star ratings lawsuit that could have implications for other plans, and a Blue Cross Blue Shield company is pulling out of the Medicare Advantage business. 

Oscar Health wants to reach 4 million members by 2027. 

Insurers are investing billions into affordable housing as they look to address healthcare challenges stemming from housing instability.

Artificial intelligence has the potential to lower internal and member costs for insurers while also increasing profits, but the industry has largely not embraced these opportunities, according to a June 5 analysis from McKinsey.

Dual-eligible special needs plan enrollees are twice as likely to have prior authorization requests denied compared to all other Medicare Advantage members, according to KFF.

California improperly used $52.7 million in federal Medicaid funds to pay for nonemergency care for Medicaid recipients without legal status, according to an audit from HHS' Office of Inspector General. 

Seven payers landed among the top 25 healthcare companies on the Fortune 500 in 2024. 

Payers are expecting to issue a total of about $1.1 billion in medical loss ratio rebates across all commercial markets in 2024, according to preliminary estimates published June 5 by KFF.