Alignment Healthcare swung to an $8 million loss as the industrywide struggle grappling with costs of care for older adults in Medicare Advantage plans lingers. Like many of its rival health insurers, particularly those in the Medicare Advantage business, Alignment has…
BCBSA: Hospitals' AI coding increases costs without adding value Payer group urges lawmakers to reject NSA enforcement bill Docs still skeptical of insurers' pledge to ease prior auth: AMA Major health plans advance efforts to standardize prior auth Insurers have…
Connecting Retail Commerce to Member Health As healthcare organizations continue their focus on helping members live healthier lives based on their unique needs and preferences, everyday retail stores are now essential destinations where members take control of their health. By…
The move follows what the health system called seven months “of engaging in good faith negotiations and extensive discussions.” According to Sanford, “Wellmark insists on having sole authority to change key contract terms after an agreement is signed, including terms…
KATV White River Health to exit UHC Medicare Advantage network Jan. 1, 2027
About 1,440 county residents may lose drug coverage, unless they pick a new plan. Free Medicare help sessions start Oct. 22. MENDOCINO CO., 10/21/26 — UnitedHealthcare is pulling its AARP Medicare Advantage plan out of Mendocino County on Jan. 1. After that, only one company…
Insurance Business Health plans have 10 weeks to meet the prior auth API deadline, and the burden hasn’t eased yet The partnership is designed for a specific regulatory moment. The Centers for Medicare and Medicaid Services (CMS) finalized the Interoperability and…
BATESVILLE, Ark. (KAIT) - White River Health announced Wednesday that its hospitals and facility-based services will leave the UnitedHealthcare Medicare Advantage network effective Jan. 1, 2027. The health system cites frequent claim denials, administrative requirements, and documentation demands that it says burden physicians…
Modern Healthcare Why big insurers are investing in shared provider data New insurer entrants are promising lower costs and closer care coordination, but analysts warn becoming a health plan remains one of healthcareâs toughest plays.
Editor’s Note (10/19/26): This article has been updated with additional statements from Sentara that WHSV received after the story’s original publication. HARRISONBURG, Va. (WHSV) - Some Anthem health insurance members are expressing concerns about what a contract disagreement with Sentara could mean…
Medicare Advantage plans and the insurers that run them: overpayments, denials, plan exits and benefit changes, star ratings and payment rates.
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