Financial / Operating Pressure
Signals classified into this topic vertical.
100 signals
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Elevance’s new site-of-care rules puts hospitals on alert
As Elevance Health prepares to implement new site-of-care billing requirements, revenue cycle leaders are raising concerns about additional administrative burdens, potential payment delays and growing complexity across payers. “My broader concern is growing variation across payers, which adds cost and creates more chances for error,” Felix Segre, director of revenue integrity at Houston-based Memorial Hermann […] The post Elevance’s new site-of-care rules puts hospitals on alert appeared firs...
ElevanceElevance Health · 16 signals · last 30 days -
Elevance reports $1.4B in Q3 profit, names Carelon president
Elevance Health logged nearly $1.4 billion in third-quarter profit for 2026, up 14.8% year over year. The company posted its earnings Oct. 21. That same day, Elevance named Jeff Park as president of healthcare services subsidiary Carelon, effective Dec. 1. Mr. Park was most recently president of health technology company Waltz Health. Along with other […] The post Elevance reports $1.4B in Q3 profit, names Carelon president appeared first on Becker's Payer Issues | Payer News .
ElevanceElevance Health · 16 signals · last 30 days -
Elevance Health posts $1.4B in profit in Q3 earnings beat
Elevance Health is boosting its outlook for the year as it beat Wall Street analysts' expectations for both profit and revenue in the third quarter.
ElevanceElevance Health · 16 signals · last 30 days -
Elevance sees Medicaid momentum in Q3
States jacked up their Medicaid rates in July, a positive development for the insurer. Elevance now thinks its Medicaid margin will be better than its prior expectation of -1.75% this year.
ElevanceElevance Health · 16 signals · last 30 days -
Where Optum’s financials stand after rolling back ‘rapid expansion’
A year after executives said Optum Health had drifted from its original value-based care model, the smaller business is producing much larger profits, according to UnitedHealth Group’s Oct. 13 earnings release and call. Optum Health’s earnings from operations rose to $735 million in the third quarter, up from $41 million a year earlier. Its operating […] The post Where Optum’s financials stand after rolling back ‘rapid expansion’ appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 46 signals · last 30 days -
Cigna accused of underpaying ground ambulances to boost its own fees
Cigna is facing a lawsuit claiming it made a profit by underpaying out-of-network ground ambulances, according to a class-action complaint filed Oct. 12 in a California federal court. The lawsuit centers on self-funded employer health plans that Cigna administers under administrative services only agreements. The plaintiff, who was covered by one of these plans, alleged […] The post Cigna accused of underpaying ground ambulances to boost its own fees appeared first on Becker's Payer Issues |...
Cigna CaliforniaCigna · 15 signals · last 30 days -
No Surprises Act arbitration awards near 6% of commercial medical spend in some regions: UnitedHealthcare
Arbitration awards under the No Surprises Act can reach nearly 6% of total commercial medical spend in some regions, UnitedHealthcare CEO Tim Noel said during an Oct. 13 earnings call. The medical cost trend for UnitedHealthcare’s commercial business is “exceeding” an initial expectation of 11%, Mr. Noel said. While Mr. Noel pointed to clinician cost […] The post No Surprises Act arbitration awards near 6% of commercial medical spend in some regions: UnitedHealthcare appeared first on Becker'...
UnitedHealthcareUnitedHealthcare · 46 signals · last 30 days -
Optum Health’s turnaround picks up speed
Optum Health’s earnings from operations climbed to $735 million in the third quarter, up from $41 million a year earlier, as UnitedHealth Group’s care delivery arm continues to recover from a challenging 2025. The unit’s operating margin rose to 3.2% from 0.2%, according to UnitedHealth’s Oct. 13 earnings release. On an adjusted basis, the margin […] The post Optum Health’s turnaround picks up speed appeared first on Becker's Payer Issues | Payer News .
UnitedHealthOptumUnitedHealthcare · 46 signals · last 30 days -
Poll: 43 percent support 'Medicare for all'
Nearly 43 percent of Americans support the idea of “Medicare for all,” according to an Axios/Ipsos poll released Tuesday, as concerns over health costs mount ahead of the midterm elections. People who said they support Medicare for all outnumbered its opponents by a nearly 2-to-1 margin, while a bipartisan majority of Americans said they think the...
Financial / Operating Pressure · 30 signals · last 30 days -
North Dakota insurance commissioner posts premium rate changes for next year
North Dakota Insurance Commissioner Jon Godfread on Monday released health insurance premium rate changes for Affordable Care Act plans for 2027. His news release includes a table of ACA small group and individual market rate increases for companies including UnitedHealthcare, Blue Cross Blue Shield of North Dakota and Sanford Health Plan. Godfread did reduce some […]
UnitedHealthcare + Blue Cross Blue Shield plans · 80 signals · last 30 days -
UnitedHealth Group beats the Street with $4.1B in profit for Q3
Another round of healthcare industry earnings reports kicked off Tuesday morning, with UnitedHealth Group reporting $4.1 billion in profit for the third quarter.
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth reports $4.1B in profit, launches AI recommendations for Medicare Advantage plans
UnitedHealth Group reported $4.1 billion in profit for the third quarter of 2026, up 75% year over year, according to an Oct. 13 release. UnitedHealth raised its full-year outlook to at least $19.50 per share, with adjusted earnings of at least $20.50 per share. The company is also rolling out AI-powered plan recommendations for the […] The post UnitedHealth reports $4.1B in profit, launches AI recommendations for Medicare Advantage plans appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth eyes Medicare Advantage opportunities, bolstered by Q3 profit growth
UnitedHealth raised its 2026 earnings guidance and outperformed analyst expectations for the third time this year, suggesting its financial turnaround is sustainable.
UnitedHealthUnitedHealthcare · 46 signals · last 30 days -
UnitedHealth, Elevance make Fortune’s list of AI pioneers
Fortune recognized five healthcare companies on its 2026 “AIQ 75” ranking. Fortune partnered with Enterprise Technology Research and pulled from ServiceNow’s Enterprise AI Maturity Index. The team assessed how Fortune 500 companies, the largest U.S. companies by revenue, deploy AI and value those investments. Fortune released its first inaugural AIQ ranking in 2025. In 2026, […] The post UnitedHealth, Elevance make Fortune’s list of AI pioneers appeared first on Becker's Payer Issues | Payer...
UnitedHealthElevanceUnitedHealthcare + Elevance Health · 61 signals · last 30 days -
I have Medigap and I’m finding it difficult to afford. What are my other options for supplemental coverage?
You may want to find out if you qualify for Medicaid, if your income and assets are low enough. Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports.
Financial / Operating Pressure · 30 signals · last 30 days -
I am covered by Medicare and my only income is $12,000 from Social Security. I have $1,000 in a savings account. Do I qualify for any financial assistance with my Medicare coverage?
Based on your current income and asset amounts, you may qualify for Medicaid. Under the current rules, Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports.
Financial / Operating Pressure · 30 signals · last 30 days -
If my employer offers retiree health benefits, do I need to sign up for Medicare when I turn 65?
For most people with retiree health benefits, it makes sense to sign up for Medicare when you are first eligible to do so. Retiree health plans are typically designed to supplement Medicare and might not pay your medical costs during any period that you were eligible for Medicare but not signed up for it.
Financial / Operating Pressure · 30 signals · last 30 days -
I am 66 years old, work for a large employer, and have health insurance coverage through my job. I am planning to keep working for a few more years and keep the coverage that my employer offers. What are my coverage options when I stop working?
When you stop working and/or your group health insurance coverage ends, you should enroll in Medicare Part A and Part B. If you’re eligible for premium-free Part A, you can sign up any time after you’re first eligible for Medicare.
Financial / Operating Pressure · 30 signals · last 30 days -
Humana reports nearly $20B economic impact in home state of Kentucky
Humana and the University of Louisville reported Oct. 6 that the company contributed nearly $20 billion to the state’s revenues and output in 2025. This includes estimates of roughly $6.4 billion in direct impact, $9 billion in indirect impact and $4.5 billion in induced impact, according to the university’s report. Here are four other things […] The post Humana reports nearly $20B economic impact in home state of Kentucky appeared first on Becker's Payer Issues | Payer News .
Humana KentuckyHumana · 13 signals · last 30 days -
HCSC halved its Medicare Advantage footprint but says it’s still playing the long game
Health Care Service Corp. has cut its Medicare Advantage footprint in half less than two years after buying Cigna’s Medicare business for $3.3 billion, but the Chicago-based insurer says the narrowed focus will allow it to achieve sustainable growth over time. The company is coming off a costly year, posting a net loss of more […] The post HCSC halved its Medicare Advantage footprint but says it’s still playing the long game appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 15 signals · last 30 days -
Trump to send $90 payments to 20 million Medicare enrollees
The White House said the federal government will send more than 20 million Medicare enrollees one-time $90 payments to help with Part B premiums in early October. An Oct. 2 White House fact sheet said the payments would come from the Medicare Improvement Fund, which was established in 2008 to strengthen fee-for-service Medicare Parts A […] The post Trump to send $90 payments to 20 million Medicare enrollees appeared first on Becker's Payer Issues | Payer News .
Financial / Operating Pressure · 30 signals · last 30 days -
The Trump Administration’s $90 Payment to Medicare Beneficiaries, Reminiscent of a Similar Proposal Six Years Ago, May Not Offset Rising Costs
Medicare’s standard Part B premium is $2,435 this year and is projected to increase by $79 annually for 2027 – meaning this increase alone would consume most of the $90 payment, which less than half of all beneficiaries will receive.
Financial / Operating Pressure · 30 signals · last 30 days -
Trump announces $90 payments for seniors’ Medicare premium costs ahead of midterm elections
President Trump is promising more payments to voters just ahead of the Nov. 3 midterm elections — this time for seniors' Medicare Part B premiums
Financial / Operating Pressure · 30 signals · last 30 days -
Medicare Improvement Fund Premium Rebate Frequently Asked Questions
Medicare Improvement Fund Premium Rebate Frequently Asked Questions Q: What will the Medicare Improvement Fund do for Medicare beneficiaries? A: The Administration is making a $90 Premium Rebate available for Part B premiums to certain Medicare beneficiaries because the best way to improve Medicare is to put healthcare dollars back where they belong – in the hands of our Medicare beneficiaries – and make coverage more affordable.
Financial / Operating Pressure · 30 signals · last 30 days -
STAT+: Medicare Advantage plans shift more costs onto seniors in 2027
Premiums are stable, but Medicare Advantage plans are making big changes that could make care more expensive for patients.
Financial / Operating Pressure · 30 signals · last 30 days