The unresolved contract dispute between UNC Health and Cigna risks out-of-network status for thousands of patients, reflecting broader insurer-provider negotiation challenges in North Carolina's healthcare market.
Pharmaceutical companies agree to significant Medicare drug price cuts under Trump administration, projecting billions in savings with impacts on Medicare Part D and drug affordability.
Rising cost pressures and demographic shifts fuel intensified disputes between payers and providers over Medicare Advantage contracts, impacting reimbursement and network participation.
Starting in 2026, MultiCare will no longer accept certain Medicare Advantage PPO plans, impacting access for some seniors. The shift focuses on HMO plans for better care coordination during Medicare open enrollment.
Texas HHSC to transition from Dual Demonstration Program to Integrated Dual-Eligible Special Needs Plan (D-SNP) model in 2026, enhancing Medicare and Medicaid integration for dual eligibles in STAR+PLUS.
Geisinger Health Plan earns 2026 Best Insurance Company for Medicare Advantage in Pennsylvania, recognized for high-quality coverage and member services based on CMS quality measures.
CMS proposes to revamp Medicare Advantage Star Ratings, affecting insurer compliance and operations. Legal appeals and health system updates also impact the US market.
KFF research reveals widespread use of chart reviews in Medicare Advantage, increasing diagnoses and boosting CMS payments with AI-driven risk adjustment implications.
SCAN Health Plan strategic response to Medicare patient challenges highlights healthcare system inefficiencies and innovation in Medicare managed care.
Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.
