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 ...

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 ...

“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 ...

Over the next several months, health plans, health systems, policymakers and patients led by Baltimore-based Johns Hopkins will begin addressing prior authorization as part of a convening group. While ...

At Becker’s Fall Payer Issues Roundtable in early November, payer and provider executives discussed the shifting realities facing health plans, from regulatory pressure and AI adoption to member ...

Health insurers spent the third quarter resetting pricing models and narrowing their product portfolios as medical cost trends remained elevated and Medicare Advantage headwinds intensified heading ...