Payer-provider dynamics have been a persistent struggle in healthcare, particularly evident in heated contract negotiations. AI — such as clinicians using scribes associated with greater coding ...

Preventive care significantly improves health outcomes—cancer screening alone has added as many as 16 million years to people’s collective lifespans. Yet only about 5% of adults receive the screenings ...

The Labor Department’s Employee Benefits Security Administration proposed regulation Jan. 29 that would require pharmacy benefit managers to disclose their compensation with self-insured group health ...

Enhanced ACA premium tax credits expired Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. A bipartisan group of senators continues negotiating, and Republicans are ...

Sen. Bernie Moreno, R-Ohio, said his party is preparing to make its “best and final offer” to extend the ACA enhanced tax credits, Politico reported Jan. 28. Mr. Moreno has been a lead negotiator in a ...

UnitedHealth Group reported its fourth quarter and full year 2025 earnings Jan. 27, projecting membership declines between 2.3 million and 2.8 million across its Medicare Advantage, Medicaid and ...

L.A. Care Health Plan has named Rob Geyer as its first chief operating and systems integration officer. Mr. Geyer will be responsible for integrating and aligning the insurer’s information technology, ...

Payer leaders are managing deeper downside risk, tighter margins and rising expectations for transparency, quality reporting and audit readiness. This guide outlines a practical framework for using AI ...

BCBS Vermont President and CEO Beth Roberts has worked all over New England — but her latest role marks her first foray into Vermont. She described the state’s insurance market as “interesting” in a ...

“Affiliation” is a buzzword in insurer partnerships. It may seem ambiguous, but this is a standard term for nonprofit M&A-type activity. A CareSource spokesperson told Becker’s that the nonprofit does ...

Major insurers are retrenching their Medicare Advantage strategies as federal cost‑containment measures and rising medical expenses squeeze profitability. Amid the growing financial pressures the ...

There are 3,719 Medicare Advantage plans available nationwide in 2025. The number of plans available to the average beneficiary is 42. 15 insurers exiting Medicare Advantage markets in 2025: This ...