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The expiration of enhanced subsidies at the end of 2025 altered the marketplace. In 2026, enrollment dropped, and the remaining…
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Newly enabled competition between Blue Cross Blue Shield plans is continuing to contribute to Elevance Health’s commercial insurance business, leadership said on the company’s quarterly earnings call Oct. 21. Dubbed the “second blue bid,” the provision stems from a $2.67…
As Elevance Health prepares to implement new site-of-care billing requirements, revenue cycle leaders are raising concerns about additional administrative burdens, potential payment delays and growing complexity across payers. “My broader concern is growing variation across payers, which adds cost and…
Molecular residual disease (MRD) testing is moving into the next phase of precision oncology, extending molecular insight past diagnosis and treatment selection into post-treatment monitoring, surveillance and survivorship. For health systems, the question is not whether to add another test.…
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The White House is withholding another $1.2 billion in federal Medicaid payments to California, citing growth in the state’s personal care services spending. CMS Administrator Mehmet Oz, MD, made the announcement Oct. 20 in the Oval Office on behalf of…
Elevance Health logged nearly $1.4 billion in third-quarter profit for 2026, up 14.8% year over year. The company posted its earnings Oct. 21. That same day, Elevance named Jeff Park as president of healthcare services subsidiary Carelon, effective Dec. 1.…
Boise, Idaho-based St. Luke’s Health System will begin offering Medicare Advantage coverage for the first time in 2027, making it one of just a handful of new entrants into the market. The launch comes as more than a dozen payers…
Value-based care promised better outcomes at lower cost. Years of effort and millions in infrastructure later, payer leaders are asking a blunt question: is it delivering? On Oct. 21, join us for a candid discussion built for payer leaders that…
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As Medicare Advantage faces concerns regarding plan oversight, possible overpayments and care access, RAND researchers assembled experts to unpack potential reforms. Published in Health Affairs Oct. 5, the study consisted of two rounds with nearly 40 panelists. They rated 15…
SCAN Health Plan launched a Medicare Advantage HMO with CareMore Health, an integrated care delivery system and primary care provider under Mosaic Health, with coverage beginning Jan. 1. According to an Oct. 13 news release, CareMore Health Plan by SCAN…
A newly introduced House bill is targeting the methodology behind Medicare Advantage star ratings, adding more pressure to a program that has seen years of litigation from insurers. The Medicare Advantage Strengthening Transparency and Accountability in Rating Systems Act, or…
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