Health Plan Profiles provide enrollment data and analysis of major developments for key health plans. Topics include commercial plan design, Medicare, Medicaid, provider contracting, and pharmacy
Health Plan Analysis reports feature a comprehensive look at the managed care market within each state, plus the District of Columbia and Puerto Rico. The product assesses payer/provider influence
Cambia markets Blue Cross Blue Shield-branded commercial and Medicare Advantage plans in the seven-county Seattle, Washington area plus Oregon, Utah, and parts of Idaho. Its Asuris subsidiary markets
Wellmark Blue Cross and Blue Shield of Iowa remains the dominant player in Iowa’s commercial insurance segment. However, UnitedHealthcare and Cigna have made considerable enrollment gains in
Former North Carolina GOP Gov. Pat McCrory signed into law House Bill 372, which privatizes the state’s nationally recognized Medicaid program, currently a medical home model called Community
South Dakota’s commercial market is dominated by IDN networks Avera Health and Sanford Health along with Wellmark Blue Cross Blue Shield. Sanford Health, Avera Health, and Wellmark Blue Cross
In Missouri, UnitedHealthcare is the dominant player in the commercial insurance landscape with the largest enrollment, followed by Anthem, Cigna, CVS Health-owned Aetna, and BlueCross BlueShield
The national antitrust settlement of a long-running antitrust suit against the Blue Cross Blue Shield Association and the nation's Blue plans is forcing significant strategic changes for the
New Orleans is consolidating around Ochsner Health System and LCMC Health, edging out rival HCA Healthcare, which has not embraced the market's steady shift to value-based care. LCMC's
Blue Cross Blue Shield of Michigan continues to dominate commercial enrollment outside of the exchange. Although COVID-19 did impact the payer mix in the state, no consequential shifts in market share
Three carriers offer plans on Montana’s federally facilitated health insurance exchange. The average premium increase across all three insurers increased by 10 percent in 2023, and likely will
The rapid spread of COVID-19 is threatening health systems and physicians in the Raleigh market with new financial challenges that will impact growth strategies in the near term. Although the market&
California’s health insurance exchange, Covered California, has the largest enrollment of all exchanges with Kaiser Foundation Health Plan, Blue Shield of California, and Centene as enrollment leaders
National MCO Analyzer provides a clear view of the shifting opportunities and barriers MCOs face in today’s commercial marketplace and offers detailed analysis of the fast-changing Medicare and
Chicago providers and payers now have more transparent patient data sharing protocols, which should improve success with a growing number of risk-based arrangements. While incentive payments still are