Blue Shield of California officials attended an April 8 hearing with the San Francisco Board of Supervisors regarding care denials for workers. The hearing followed reporting from the NBC Bay Area ...

It is no secret that prior authorization has long been a sore subject between payers and providers. In June 2025, insurers committed to easing prior authorization requirements. Now, AHIP (formerly ...

In 2024, the uninsured rate grew for the first time since 2019, according to an April 9 KFF issue brief. KFF reviewed data on uninsured trends and demographics in recent years, focusing on individuals ...

As administrative costs rise and reimbursement grows more complex, both health plans and providers are under increasing pressure to improve the payment experience. Faster payment remains important, ...

Blue Cross Blue Shield plans faced widespread financial pressure in 2025, with several major insurers posting operating losses as medical and pharmacy costs continue to climb. The struggles played out ...

Nebraska will roll out Medicaid work requirements in May, making it the first expansion state to implement these provisions under HR 1. Here are four notes leading up to Nebraska’s launch: 1. Medicaid ...

CMS is raising Medicare Advantage payments by 2.48%, or more than $13 billion, according to its finalized 2027 rate announcement. The agency said April 6 that when estimated risk score trends in MA ...

Washington, D.C. has the highest average monthly premium for ACA enrollees who received advance premium tax credits in 2026, while Texas has the lowest, according to a KFF analysis. After enhanced ...

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory ...

The day after CMS released its final 2027 Medicare Advantage and Part D payment rule, Chris Klomp, director of Medicare and deputy administrator at the agency, sat down with Health Tech Nerds Radio ...

As the Medicaid cuts from H.R. 1 begin to settle in, states are looking for workarounds to continue funding their programs. Iowa Republican Gov. Kim Reynolds signed a bill March 25 allowing a steeper ...

Thirty-six percent of providers believe payers reliably deliver on promises, according to an inaugural Aetna provider survey released April 8. The survey will run quarterly, polling representatives of ...