AM Best schedules a briefing on January 15, 2026, addressing pressure points and market outlooks in Medicare Advantage and Medicaid Managed Care sectors amid rising costs and utilization trends.
UnitedHealthcare limits RPM coverage to select conditions in 2026 amid growing Medicare RPM use, signaling shifts toward value-based care and enhanced oversight.
Humana appoints Aaron Martin as President of Medicare Advantage, reshaping its insurance segment leadership ahead of George Renaudin's retirement in 2026. This transition aims to strengthen operational excellence and market position in Medicare and Medicaid.
The AMA's 2024 report reveals significant concentration in U.S. commercial and Medicare Advantage health insurance markets, raising concerns over competition and consumer choice.
A contract dispute between Optum and Humana in Washington state spotlights risks of vertical integration in Medicare Advantage, impacting senior beneficiaries and market competition.
Internal Humana data revealed higher hospitalization rates in their Medicare Advantage clinics than publicly reported, raising questions on integrated care outcomes and investor transparency.
Humana's fair value rises slightly on stronger revenue growth assumptions despite mixed analyst ratings amid Medicare Advantage regulatory challenges and sector cyclicality.
U.S. Senators propose legislation to halt CMS AI-powered Medicare prior authorization pilot in six states including Washington due to care delay concerns.
CMS 2027 Proposed Rule aims to modernize Medicare Advantage and Part D programs with updates to quality metrics, risk adjustment models, and beneficiary protections. Key changes include Star Ratings revisions, incorporation of Inflation Reduction Act drug pricing provisions, and requests for stakeholder feedback on quality bonus payments and care coordination.
Discover how 2026 CMS compliance deadlines and cybersecurity expectations are reshaping payer IT with FHIR interoperability, prior authorization modernization, and outcomes-driven digital strategies.
