Financial / Operating Pressure
Signals classified into this topic vertical.
60 signals
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Blue Shield of California sister company debuts AI copilot for health plan customer service reps
Stellarus, a healthcare technology company born out of a Blue Shield of California restructuring, is rolling out its AI-powered Customer Service Representative Chat for health plan customer service representatives. According to a July 30 news release, CSR Chat is Stellarus’ first commercially available product within its Compass suite, an AI-driven engagement platform for health plans. […] The post Blue Shield of California sister company debuts AI copilot for health plan customer service rep...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 20 signals · last 30 days -
Cigna profit jumps but Express Scripts stumbles
Express Scripts is adapting to significant changes in its pharmacy benefit manager model.
CignaCigna · 10 signals · last 30 days -
BCBS Michigan to move 1,400 employees from Detroit office as insurer hones real estate strategy
Blue Cross Blue Shield of Michigan is moving more than 1,400 employees from its Detroit office in the Renaissance Center to other facilities downtown, the company told Becker’s July 30. “The move will improve the workplace experience for our employees, while enhancing utilization of our existing space, supporting collaboration in a hybrid work environment and […] The post BCBS Michigan to move 1,400 employees from Detroit office as insurer hones real estate strategy appeared first on Becker's...
Blue Cross Blue Shield plans · 20 signals · last 30 days -
Payer CEOs sharpen their attacks on No Surprises arbitration
Another health insurance CEO is taking aim at the No Surprises Act’s arbitration system. “We do support the overall strategic intent of consumer protection from surprise billing. However, we’re seeing some clear abuses of the IDR vehicle in practice,” Cigna Group President and CEO Brian Evanko said on the company’s second-quarter earnings call July 30, […] The post Payer CEOs sharpen their attacks on No Surprises arbitration appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 10 signals · last 30 days -
Cigna bumps outlook as Q2 profit reaches $1.7B
The Cigna Group reported a profit of $1.7 billion for the second quarter of 2026, a year-over-year increase of more than 8%, according to a July 30 earnings report. Total revenue reached $71.7 billion for the quarter, up about 7% from the same period in 2025. The company attributed the revenue bump to growth across […] The post Cigna bumps outlook as Q2 profit reaches $1.7B appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 10 signals · last 30 days -
Cigna boosts outlook as it posts Q2 beat on earnings, revenue
Cigna is raising its outlook for the year after beating the Street on both earnings and revenue in the second quarter of 2026.
CignaCigna · 10 signals · last 30 days -
Cigna’s profits jump thanks to employer-sponsored plans
Cigna increased its 2026 earnings outlook following the second quarter, unbothered by inflated costs for surprise billing dispute resolutions reported by its peer UnitedHealth.
UnitedHealthCignaUnitedHealthcare + Cigna · 44 signals · last 30 days -
Margin improvements underpin Centene's strategy for 2027 ACA plans, CEO says
Centene reported $1.1 billion in profit for the second quarter of 2026, rebounding from a loss a year ago.
CenteneCentene · 11 signals · last 30 days -
19 health plan C-suite exits in 2026
From regional plans to large, for-profit health insurers, 2026 has marked a year of executive transition. Here are 19 C-suite executives who recently shared plans to leave their organization: 1. Brian Ternan, most recently president and CEO of Centene’s Health Net, is transitioning to serve as executive vice president of commercial business at GuideWell, the […] The post 19 health plan C-suite exits in 2026 appeared first on Becker's Payer Issues | Payer News .
CenteneCentene · 11 signals · last 30 days -
Humana to exit more Medicare Advantage plans in 2027
The insurer is laser-focused on reaching margin targets, and will sacrifice some plans with lower returns next year to do so, CFO Celeste Mellet said.
HumanaHumana · 13 signals · last 30 days -
‘Back on track’: Centene swings to more than $1B in profit in Q2
The managed care giant raised its 2026 earnings outlook for the second time this year following the results, which its CFO called “fantastic.”
CenteneCentene · 11 signals · last 30 days -
For big payers, is insurance still the point?
The country’s biggest payers have been branching out beyond insurance for years. Now, that trend is becoming even more pronounced. Second-quarter earnings have kicked off yet again, signaling how reliant these companies have become on their services units — and how much they keep investing there. UnitedHealth Group and Elevance Health reported earnings earlier this […] The post For big payers, is insurance still the point? appeared first on Becker's Payer Issues | Payer News .
UnitedHealthElevanceUnitedHealthcare + Elevance Health · 45 signals · last 30 days -
Molina continues to downsize exchange business
Molina Healthcare will continue to shrink its exchange business, President and CEO Joseph Zubretsky said on a July 23 earnings call. In 2026, Molina put forward average rate increases of 30% to help reduce the company’s marketplace footprint, Mr. Zubretsky said on the call. “What we can control is how much capital we’re willing to […] The post Molina continues to downsize exchange business appeared first on Becker's Payer Issues | Payer News .
MolinaMolina Healthcare · 1 signal · last 30 days -
Massachusetts negotiates $72M in rate reductions, rejects Fallon’s rate hike for 2027
The Massachusetts Division of Insurance has renegotiated lower rates — projecting $72 million in premium savings — with insurers in the state’s merged individual and small employer market. The negotiations included Blue Cross Blue Shield of Massachusetts HMO Blue, Harvard Pilgrim Health Care, Health New England, Mass General Brigham Health Plan, Tufts Health Public Plans, […] The post Massachusetts negotiates $72M in rate reductions, rejects Fallon’s rate hike for 2027 appeared first on Becke...
Blue Cross Blue Shield plans · 20 signals · last 30 days -
Molina to pull back on exchanges as costs mount
Molina Healthcare upped its earnings guidance based on optimism about its Medicaid business.
MolinaMolina Healthcare · 1 signal · last 30 days -
Cigna aims to save $200M in 3 years by expanding AI-enabled care management
Cigna Healthcare estimates $200 million in medical cost reductions over three years by enhancing its care management programs with expanded AI-enabled capabilities. In a July 23 news release, the insurer aims to reach roughly 20% more customers with complex or chronic health needs — such as cancer, high-risk pregnancy or behavioral health conditions — with […] The post Cigna aims to save $200M in 3 years by expanding AI-enabled care management appeared first on Becker's Payer Issues | Payer N...
CignaCigna · 10 signals · last 30 days -
Molina raises earnings guidance as profits drop 76% in Q2
Molina Healthcare reported $60 million in net income for the second quarter of 2026, a 76% year-over-year drop from $255 million. The insurer attributed the decline mainly to lower premium revenue and a higher medical loss ratio. Total revenue for the quarter was nearly $10.9 billion, down 4.8% year-over-year. Even with the profit decline, Molina […] The post Molina raises earnings guidance as profits drop 76% in Q2 appeared first on Becker's Payer Issues | Payer News .
MolinaMolina Healthcare · 1 signal · last 30 days -
Health insurers use a whole arsenal of tools to deny care, increase profit
Last summer, the Trump administration, physician advocates, public health academics and activists requested a voluntary commitment from commercial health insurance industry CEOs to streamline the prior authorization process. Commercial health insurance companies like UnitedHealthcare, Cigna, Aetna, CVS Health, Humana and others signed onto a six-part voluntary pledge, understanding they would be required to reach a […]
UnitedHealthcareHumanaUnitedHealthcare + Humana · 47 signals · last 30 days -
Guidance issued on new claims processing codes following independent dispute resolution updates
The Centers for Medicare & Medicaid Services released guidance July 17 on new remittance advice remark codes required for use following updates to the No Surprises Act independent dispute resolution process. RARCs are standardized codes that convey information about claims processing. The guidance specifies circumstances in which group health plans and health insurance issuers offering group or individual health insurance coverage must use each RARC and technical instructions to facilitate us...
Financial / Operating Pressure · 13 signals · last 30 days -
Proposed bill would create Medicare exchange plan, make enhanced ACA subsidies permanent
A newly proposed federal bill would create a government-run public health insurance option sold on the ACA exchanges and permanently extend the enhanced premium subsidies that lapsed at the end of 2025. The Medicare-X Choice Act, introduced July 15 by Rep. Angie Craig, D-Minn., would establish a “Medicare Exchange health plan,” on the individual and […] The post Proposed bill would create Medicare exchange plan, make enhanced ACA subsidies permanent appeared first on Becker's Payer Issues | P...
Financial / Operating Pressure · 13 signals · last 30 days -
Elevance Health leaves D.C. Medicaid market, mulls future exits
Elevance Health is kicking off another round of quarterly earnings results for major insurers, posting $1.5 billion in profit for Q2.
ElevanceElevance Health · 11 signals · last 30 days -
UnitedHealth Group to stay 'restless' even after topping investor's Q2 expectations, CEO says
UnitedHealth Group boosted its outlook for the year on the back of $5.5 billion in profit for the second quarter.
UnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Manufacturer Effectuation of MFP Draft Guidance for 2028 Medicare Drug Price Negotiation
Medicare Drug Price Negotiation Program: Draft Guidance for Manufacturer Effectuation of the Maximum Fair Price in 2028
Financial / Operating Pressure · 13 signals · last 30 days -
UnitedHealthcare: No Surprises arbitration system ‘needs to be reformed’
UnitedHealthcare is the latest insurer calling for an overhaul of the No Surprises Act’s arbitration system. “The IDR process is not working, certainly not as Congress intended it, and it needs to be reformed,” Dan Kueter, CEO of the insurer’s employer and individual business, said on UnitedHealth Group’s second-quarter earnings call July 16. Mr. Kueter […] The post UnitedHealthcare: No Surprises arbitration system ‘needs to be reformed’ appeared first on Becker's Payer Issues | Payer News .
UnitedHealthcareUnitedHealthUnitedHealthcare · 34 signals · last 30 days -
STAT+: Despite earnings celebration, UnitedHealth signals more financial pain for employers
Insurance giant UnitedHealth signals the cost of providing workers with health insurance will climb even higher.
UnitedHealthUnitedHealthcare · 34 signals · last 30 days