For too long, the healthcare system has been reactive, focused on treating illness after it occurs rather than anticipating and preventing it. At the same time, consumers have come to expect ...

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 ...

Becker’s connected with 17 health plan leaders to learn how their organizations are shifting their priorities in response to continued medical cost trends and affordability concerns. Like what you see ...

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 ...

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 ...

Point32Health — which includes Harvard Pilgrim Health Care and Tufts Health Plan — appointed Marti Lolli as executive vice president, chief growth officer, and Jeff Weiss as executive vice president, ...

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 ...

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 ...

Medicare Advantage insurers made almost 53 million prior authorization decisions in 2024, according to a Jan. 28 KFF analysis. KFF relied on insurer data reported to CMS, focusing on service ...

Ten health technology companies have pledged more than $600 million in no-cost and discounted services to help states implement Medicaid work requirements. According to a Jan. 29 news release from CMS ...

CMS proposed its 2027 Medicare Advantage and Part D capitation rates and payment policies Jan. 26, putting forth a slowdown in payment growth after a $25 billion boost for 2026. The proposed policies ...

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, ...