Payer

The four largest pharmaceutical benefit managers account for 70% of the market, an analysis from the American Medical Association found. 

From UnitedHealthcare releasing details about its national gold-card program to a reform bill in California clearing one of its final legislative hurdles, here are six updates on prior authorization that Becker's has reported since Aug. 20: 

Insurers and employers face ongoing challenges in covering costly GLP-1 medications, with coverage rates varying significantly based on the individual's insurance plan and employer.

Come mid-October, the Medicare Advantage program will enter its annual enrollment period, marked by significant changes for older adults.

Medicare Advantage plans are tasked with educating members about significant changes coming to the program in 2025. They also have to find a way to break through the noise of an election year. 

Major Medicare Advantage carriers have been reporting an increase in inpatient care costs during the first half of 2024, influencing future pricing and plan design strategies.

New York state residents will see some of the largest premium increases on the ACA marketplace in 2025, according to an analysis from Peterson-KFF.

Fifty insurers are looking to lower premiums on an ACA marketplace in 2025, according to an analysis from Peterson-KFF.

Medicare Advantage beneficiaries are getting savvier and expecting more from their plans, executives at the top-rated insurers for customer satisfaction told Becker's. 

Interest in Cigna's GLP-1 management program is "through the roof," CEO David Cordani told investors.