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 closed its second quarter of the year with a billion dollars of operating income and a $3.3 billion bottom line—but operating headwinds on the horizon have leadership taking a hard look at the health system’s cost structure and potential efficiencies. The quarter’s performance is a step ahead of last year, when the integrated ...
The drug price negotiation program has withstood another procedural effort in striking down one of the Inflation Reduction Act’s most significant provisions. In the U.S. Court of Appeals for the 6th Circuit, a panel of judges upheld (PDF) a lower court’s decision to dismiss the lawsuit. A judge dismissed the lawsuit last year, saying most of the ...
A new analysis from KFF and Health Management Associates takes a dive into prior authorization practices for Medicaid managed care organizations. The study polled state programs on policies in place as of July 2024 and found that more than half of the 36 states that responded required that insurers make “standard” prior auth determinations within seven days ...
Nevadans who get medical insurance through Nevada Health Link may see their premiums rise dramatically next calendar year, new data released by the state suggests. Nevada Health Link, formally known as the Silver State Health Insurance Exchange, is the state’s Affordable Care Act marketplace. The Nevada Division of Insurance on Thursday announced that carriers offering ...
A new study by Madaket Health found that insured Americans delay or skip essential health care due to rising costs and complexity of coverage. Many younger Americans are actually going out of their way to pay for care themselves.
President Trump sent letters Thursday to 17 of the world’s largest drug companies, telling them to take more steps to slash the prices of prescription drugs to match the lowest price in certain foreign countries.
The health IT arm of the Department of Health and Human Services finalized a rule this week that federal leaders say will remove red tape and enable faster prior authorization and real-time prescription benefit checks. The policy changes also will improve electronic prescribing standards, the agency said. The final rule, called the Health Data, Technology, ...
The nation’s four largest pharmacy benefit managers control two-thirds of the market. This high concentration, along vertical integration between PBMs and insurers, may contribute to higher prices and lower reimbursement rates, according to a new report from the American Medical Association. “These are important findings, because low competition may lead to higher prices paid by ...
UnitedHealthcare CEO Tim Noel offered investors a deeper look at the medical cost spike that’s plaguing the insurance giant’s finances. He said during the company’s earnings call Tuesday morning that pricing assumptions set by the company “were well short of actual medical costs” for 2025. UHC’s current outlook, he said, instead reflects an additional $6.5 ...
Some dental insurance issuers might be attracting employer customers with first-year prices that are too low to last. Amy Friedrich, president of the Benefits & Protection business at Principal Financial Group, talked about dental plan competition earlier this week during a conference call with securities analysts. “We are definitely seeing new-sales rates that are competitive,” Friedrich said. ...