Industry Updates
This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.
Kaiser Permanente reported nearly $1.7 billion in operating income (4.6% operating margin) during the second quarter of 2026, a more than $600 million improvement over the same period in 2025. The country’s largest nonprofit health system, in a quarterly financial update shared Friday that precedes its more granular regulatory filing, outlined $35.6 billion in operating ...
Thomas Zordani flew from his home in Denver to Phoenix for a consultation with a Mayo Clinic neurosurgeon, hoping to find out what could be done to treat his debilitating headaches after worrisome brain scan findings. When making the appointment, Zordani said, he’d been told the clinic was in his insurer’s network. Upon arrival, Zordani ...
A federal appeals court on Tuesday struck down a formula used by healthcare providers, insurers and the government that is designed to shield patients from staggeringly high “surprise” medical bills. In an unsigned decision, a majority of the 17-judge 5th U.S. Circuit Court of Appeals in New Orleans assured the ruling would not lead to ...
A health care advocacy group on Thursday sued the American Medical Association in an effort to get more transparency over the association’s billing codes, which guide billions of dollars in health care payments. PatientRightsAdvocate.org hopes to republish the codes online and allow the public to search them free. The group, which has pushed for health care ...
SCAN Health Plan and Costco will roll out insurance products for older adults in the coming years, according to an Aug. 18 news release. The Wall Street Journal reported that the companies would begin by selling jointly branded Medicare Advantage products in two states, as well as a Medicare supplement in a third state. While the geography was ...
The Pharmaceutical Care Management Association announced Thursday that its members had reached an agreement with the feds to offer information on cash prices available through TrumpRx. The commitment encompasses nine of the industry’s leading pharmacy benefit managers, including the “Big Three” in CVS’ Caremark, UnitedHealth Group’s Optum Rx and Cigna’s Express Scripts. Other participants that have signed ...
“This story was originally published by CalMatters. Sign up for their newsletters.” Two years ago, California hit a milestone decades in the making: Nearly every person in the state qualified for health insurance, regardless of immigration status and income, pushing the state’s insured rate to a record 95%. Now that progress is unravelling. Facing budget ...
Employer health plans that pay out-of-network doctors or hospitals less than the providers billed now have to tell the providers exactly what plan is paying the bill. A plan that “downcodes” a claim must also give the provider some information about why it downcoded the claim. The new claim payment message requirements took effect last ...
A House Republican has introduced a new, expanded version of his Great American Healthcare proposal. Rep. Eric Burlison, R-Mo., filed a Great American Healthcare Act bill earlier this week. The bill is similar to the Great American Healthcare Plan bill that Burlison introduced in April. Like the earlier bill, the new Great American Healthcare bill ...
Medi-Cal cuts will strain hospitals already operating at a loss. The fallout: fewer services and higher costs for the privately insured too.