Payer

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

Alignment Healthcare's membership grew more than 58% in 2024, driving the Medicare Advantage company to nearly 190,000 members.

A special master has recommended a more than decade-old lawsuit against UnitedHealth Group be thrown out, which alleges the company overcharged the federal government through Medicare Advantage claims.

Blue Cross Blue Shield of Michigan reported a loss of $1.02 billion on enterprise revenue of $40.6 billion in 2024, driven by rising utilization of expensive medical services and costs for prescription and specialty drugs.

Minnesota Gov. Tim Walz has proposed shifting the cost of managing the state's ACA reinsurance program from the state to private insurers, along with raising the state's tax on health maintenance organizations.

Excellus BlueCross BlueShield posted $25.6 million in net income for 2024, the Buffalo News reported March 3.

Executive Summary: Health plans must ensure network adequacy to meet regulatory requirements, maintain consumer trust, and provide a fulfilling member experience. However, network adequacy remains a fundamental challenge for plans due to inaccuracies in provider data. Health plans struggle with…

Highmark Western and Northeastern New York reported a net loss of $140 million in 2024, Buffalo Business First reported Feb. 28.

UnitedHealth Group has more than 2.8 million enrollees in special needs Medicare Advantage plans in 2025, according to CMS data published Feb. 25. 

Maryland has sanctioned Medicaid managed care organization Priority Partners following the suspension of its health plan accreditation by the NCQA.