Changes could be coming for Medicaid in the next presidential administration. In his first term in office, President-elect Donald Trump's administration backed block grant funding for the program, and ...

UnitedHealthcare has prevailed in its lawsuit against CMS regarding the methodology used to calculate its 2025 Medicare Advantage star ratings. The lawsuit, filed Sept. 30 in the U.S. District Court ...

Employer-sponsored insurance costs rose about 5% in 2024, driven in part by coverage of expensive weight loss medications, according to Mercer's National Survey of Employer-Sponsored Health Plans.

Payer executives shifted their focus to population health and implemented new strategies in 2024. The five executives featured in this article are speaking at Becker's Spring Payer Issues Roundtable.

States spend nearly $40 billion annually on expanded Medicaid coverage under the ACA, according to KFF. Medicaid is financed by the federal government and the states based on per capita income. The ...

Weight loss management is a common component of many corporate wellness programs. Health plans often offer such programs as a way to encourage plan members to lead healthier lives, while ...

Untreated mental health conditions often prevent people from seeking medical care, leading to more expensive emergency treatments. Personalized, targeted outreach based on AI-enabled insights can help ...

Prospective CMS Administrator Mehmet Oz, MD, has been a major proponent of Medicare Advantage, and has pitched expanding the program to extend coverage to all Americans. President-elect Donald Trump ...

Almost half of the nation's local commercial insurance markets are majority controlled by one payer, according to the American Medical Association. The AMA's annual "Competition in Health Insurance" ...

Most Medicare Advantage markets are highly concentrated, but in a handful of markets, one payer controls more than 70% of the MA landscape, according to the American Medical Association's annual ...

The average Medicare beneficiary will have 34 Medicare Advantage plans available to them in 2025, with Pennsylvania being the highest at 71 plans, according to KFF. In 28 states, the average ...

Primary care accounts for more than 35% of U.S. healthcare visits, but only 5% of healthcare spending. To address this gap, a California agency has set a goal for insurers in the state to direct 15% ...