AM Best revises US health insurance outlook to negative due to rising medical utilization, increased specialty drug use, and regulatory challenges impacting Medicare Advantage and Medicaid programs. Premiums projected to rise up to 60% by 2025.
Wellth secures $36 million Series C funding to enhance its AI-driven platform that improves medication adherence and preventive care in Medicare Advantage and Medicaid populations.
Medicare Advantage plans face a 29-point drop in member satisfaction driven by rising medical costs and digital engagement challenges, reports J.D. Power. Rising expenses and regulatory scrutiny pressure insurers to improve service and transparency.
The 2025 J.D. Power Medicare Advantage Study identifies declining member satisfaction and highlights how digital onboarding and transparency improve member trust across U.S. Medicare Advantage plans.
Physician incomes from Medicare have fallen over 33% since 2016 due to stagnant reimbursements and increased costs, prompting health systems to reconsider Medicare Advantage participation. This shift threatens patient access and could reshape Medicare's physician landscape.
Congressman Schweikert introduces H.R.3467 to auto-enroll seniors in Medicare Advantage with a three-year lock-in, raising questions on beneficiary rights and plan flexibility.
The Congressional Budget Office warns the new tax and spending law may trigger nearly $500 billion in Medicare cuts over 10 years via S-PAYGO sequestration, impacting providers, rural hospitals, and Medicare Advantage plans.
Explore how CMS's Medicare Advantage Star Rating system's opaque methodologies create regulatory arbitrage and financial risks for insurers like Elevance Health, Humana, and UnitedHealthcare, shaping the healthcare insurance landscape.
CareOregon will discontinue out-of-network behavioral health coverage for Medicaid and Medicare Advantage members, impacting 15,000 patients in Oregon. The change aligns with industry practices post-COVID-19 expansion.
Texas federal judge rules against Elevance Health in lawsuit over Medicare Advantage star ratings, impacting $375 million in bonus revenue. CMS methodologies upheld.
