Financial / Operating Pressure
Signals classified into this topic vertical.
100 signals
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‘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 · 13 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 · 61 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 · 2 signals · 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 · 36 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 · 2 signals · 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 · 15 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 · 2 signals · 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 · 59 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 · 30 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 · 30 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 · 16 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 · 46 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 · 30 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 · 46 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 · 46 signals · last 30 days -
UnitedHealthcare recovery in swing but challenges remain
UnitedHealth Group profits are up as its insurance operations emerge from a difficult period.
UnitedHealthcareUnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth posts $5.5B profit in Q2
UnitedHealth Group posted nearly $5.5 billion in profit for the second quarter of 2026, up sharply from the same period last year. The company released second-quarter earnings July 16, raising its full-year outlook to a range of $18.45 to $18.95 per share, with adjusted earnings of $19.50 to $20.00 per share. UnitedHealth GroupRevenue was $112 […] The post UnitedHealth posts $5.5B profit in Q2 appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth reports quarterly profit above Wall Street estimates
The results are a hopeful sign for UnitedHealth Group’s financial recovery.
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth raises 2026 guidance again as cost controls pay off in Q2
UnitedHealth’s profit spiked to $5.5 billion in the second quarter thanks to notable earnings recovery in its insurance and value-based care delivery businesses. The healthcare juggernaut delivered for investors, analysts said.
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
Elevance Health previews Medicaid exits as profit slips
Elevance Health will avoid federal sanctions on its Medicare Advantage operations, executives said Wednesday.
ElevanceElevance Health · 16 signals · last 30 days -
Elevance slides as profit guidance raise fails to impress
Elevance Health may foresee financial challenges in the later part of the year.
ElevanceElevance Health · 16 signals · last 30 days -
Alignment faces whistleblower lawsuit over accounting claims
A former Alignment Healthcare executive alleges the Medicare Advantage insurer misclassified expenses to inflate earnings and executive pay.
Alignment HealthcareAlignment Healthcare · 3 signals · last 30 days -
GoHealth, Inc.
Case 26-10914-TMH Doc 4 Filed 06/07/26 Page 1 of 41 IN THE UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF DELAWARE ) In re: ) Chapter 11 ) GOHEALTH, INC., et al.,1 ) Original document
GoHealth Delaware -
Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
This brief provides information about Medicare Advantage plans in 2026, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
Financial / Operating Pressure · 30 signals · last 30 days -
Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price
WASHINGTON — Voters across party lines say seniors will face higher costs and reduced benefits if Medicare Advantage funding doesn’t keep pace with rising medical costs — and warn it … Continue reading "Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price" The post Bipartisan Majority of Voters Say Proposed Medicare Advantage Payment Rate Is Inadequate and Seniors Will Pay the Price appeared first on Better Medicare Alliance .
Financial / Operating Pressure · 30 signals · last 30 days