Elevance Health will exit the small group ACA market in Ohio in 2027, the company confirmed with Becker’s. “Small businesses are increasingly seeking health coverage options that deliver affordability ...

Payers are continuing to trim their workforces amid financial pressures, growing medical and pharmacy utilization, Medicaid funding cuts and strategic restructuring. Below are workforce reduction ...

The ground is shifting beneath the healthcare industry, and payers know it. With federal Medicaid funding under scrutiny, enhanced ACA subsidies expired, value-based care models continuing to evolve, ...

Most patients never see utilization management (UM) in action. It is how health plans and providers work together to confirm that care is safe, necessary, covered ...

Vermont has the highest average ACA benchmark premium in 2026, while New Hampshire has the lowest, according to KFF. The U.S. average is $625. Premiums were analyzed using the second-lowest cost ...

Marketplace enrollment soared at over 24 million plan selections for 2025, but the enhanced premium tax credits that enabled this surge are set to expire at the end of the year. Some 4.8 million ...

Cigna Healthcare offers the best digital experience to commercial members, while UPMC Health Plan provides the best experience to Medicare Advantage enrollees, according to JD Power’s 2026 U.S.

Blue Cross Blue Shield companies have the largest market share among commercial insurers in the majority of states, according to the American Medical Association’s annual “Competition in Health ...

UnitedHealth Group reported fourth-quarter and full-year 2025 earnings Jan. 27. Profits took a hit, with the company attributing drops to Medicare funding reductions, the Inflation Reduction Act, ...

There are major changes afoot for Medicare Advantage plans in 2024 and when they are required to cover inpatient services in hospitals for their members. The changes are likely to present challenges ...

The NCQA published its 2025 ratings of health plans Sept. 16, evaluating plans on nearly 50 assessments of quality outcomes and member experience. Just 11 plans out of the nearly 1,000 rated received ...

A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny ...