California’s Department of Managed Health Care fined three Centene-owned health plans a total of $1.7 million over concerns about not meeting reporting rate standards for timely access of appointments ...
On Dec. 15, CMS published 24 quality and efficiency measures under consideration for adoption in Medicare programs. HHS employs this pre-rulemaking process to decide on measures for Medicare programs ...
Coming into 2025, health insurance industry leadership encountered overwhelming uncertainty. Following last year’s fatal shooting of UnitedHealthcare CEO Brian Thompson, insurers — including their ...
Nearly half of health plan coverage denials that reached independent medical review were overturned between 2019 and 2023, with significant variation by state, according to a Health Affairs study ...
Traditional Medicare could have saved $7 billion from 2019 to 2023 across four services had it mirrored Medicare Advantage’s utilization rates and fraud strategies, according to a December Berkeley ...
Insurers are publishing incomplete price transparency data, with hospital inpatient information particularly sparse, according to a study published in the American Journal of Managed Care in December.
UnitedHealth Group continues to be the largest health insurer in the U.S., with nearly 45 million members in 2025, according to the Peterson-KFF health system tracker. The data is from Mark Farrah ...
Average worker contributions toward family insurance premiums grew by 308% between 1999 and 2024, according to a Dec. 8 research letter published in JAMA Network Open. Researchers from Rice University ...
Throughout 2025, health insurance leaders have weighed in on the role AI should play in the industry, from advancing operational efficiencies to integrating with consumer-facing technology. Here are ...
Kaiser Permanente is the largest insurer by enrollment in the fully insured large group market, UnitedHealth Group is the largest within the fully insured small group market, and Centene is the ...
Highmark recently shared how it increased generic and biosimilar access to members, focusing on drugs for multiple sclerosis, cancer and autoimmune conditions. The insurer has been working with ...
The payer-provider relationship is continually evolving. Becker’s connected with 13 health plan leaders to find out which part of that relationship they would change. Like what you see here? Join us ...
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