News
New advisory firm assesses health vendors for fiduciary integrity | Managed Healthcare Executive
3+ hour, 53+ min ago (157+ words) Judi Group brings together top benefits specialists, ERISA attorneys, actuarial analysts, and technologists to assess risk and protect fiduciary integrity across vendors and solutions. Judi Health, the company behind Capital Rx, has launched Judi Group, an advisory firm dedicated to…...
AHIP lays blame for rising healthcare costs on hospitals, private equity
4+ hour, 29+ min ago (200+ words) The trade associations salvos came the day before the CEOs of five major insurers are expected to face tough questioning at two congressional hearings. In a pair of news releases today, the main trade association for the U.S health insurance…...
Will the end of enhanced ACA subsidies mean the beginning of a health insurance crisis? | Managed Healthcare Executive
1+ mon, 5+ day ago (896+ words) Enrollment in Affordable Care Act health plans has soared because of enhanced subsidies enacted during the COVID-19 public health emergency. Democrats (and perhaps some moderate Republicans) want them continued. Republicans say they have better ideas about how to keep Americans…...
Biosimilar competition could surpass IRA-negotiated savings by year three | Managed Healthcare Executive
1+ mon, 1+ week ago (315+ words) A new Tufts study found that Medicare price negotiations on biologics with imminent biosimilars could lead to near-term savings, but greater savings are likely from biosimilar competition. Selecting biologics facing biosimilar competition for Medicare price negotiations under the Inflation Reduction…...
Transparency paves the way for lower costs and equitable access | Managed Healthcare Executive
1+ mon, 2+ week ago (240+ words) Drug and hospital prices are top employer healthcare concerns as costs rise, but some employers are unable to access their data, finds a survey by the National Alliance of Healthcare Purchaser Coalitions. Employer healthcare costs continue to rise, with high-cost…...
Who will pay for Trump program to have Medicare cover GLP-1s for obesity? | Managed Healthcare Executive
2+ mon, 3+ hour ago (680+ words) A pilot program limiting the patient co-pay to $50 could burden Part D plans, depending on whether manufacturers discount their prices " and by how much. A new Medicare Part D and Medicaid pilot program, expected to begin in April 2026, would provide…...
Independence Blue Cross Medicare Advantage plans earn high CMS ratings again | Managed Healthcare Executive
2+ mon, 5+ hour ago (281+ words) This year marks the fifth consecutive year Independence Blue Shield has received high marks for their Medicare plans. The Centers for Medicare and Medicaid Services have rated Independence Blue Cross's Medicare Advantage plans high Star Ratings for 2026, specifically their Keystone…...
Cost of health insurance expected to exceed $18,500 per employee in 2026, survey shows | Managed Healthcare Executive
2+ mon, 1+ day ago (458+ words) Health benefit costs for employees are projected to rise 6.7% in 2026the largest increase in 15 yearsas employers grapple with escalating prescription drug prices, growing GLP-1 coverage and a broader push to offer diverse, cost-saving health plan options amid mounting affordability concerns. The…...
Insurance Coverage, Not Substitution Rules, Fueled Semglee’s Adoption | Managed Healthcare Executive
2+ mon, 3+ day ago (455+ words) The findings in a new study published in Health Affairs suggest that Semglee's interchangeability status may have partially increased adoption by supporting improved formulary coverage. Improved insurance coverage likely drove increased adoption of Semglee (insulin glargine-yfgn) rather than its status…...
Health Plans Beware: Keep Contract Language Tight If Your PBM Wants Rebate Guarantees Renegotiated Because of the IRA and Biosimilars | AMCP Nexus 2025 | Managed Healthcare Executive
2+ mon, 1+ week ago (344+ words) Milliman's Jennifer Cruz says plans are losing rebates because of steep price discounts negotiated under the Inflation Reduction Act. but that they need to be sure that renegotiation of rebate guarantees doesn't get too broad. Starting next year, 10 drugs selected…...