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.
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.
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.
Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.
Examining Aetna's new inpatient payment policy for Medicare Advantage plans, its conflicts with Medicare's Two-Midnight Rule, and implications for hospital reimbursement and compliance.
Banner Health's insurance plan integrates health system data and AI technology to improve care coordination, compliance, and member experience in Medicare and Medicaid markets.
Medicare Advantage plans are advancing outcomes by integrating clinical excellence, AI-driven engagement, health literacy, and community partnerships to support holistic member care.
