We analyzed six years’ worth of large group health filings in California, yielding key insights on allowed costs as a percentage of Medicare and other findings.

We review how MA-Part D carriers adjusted their $0-premium PPO offerings in response to margin compression.

The expiration of enhanced ACA subsidies resets market dynamics, reshaping enrollment patterns and risk pools across the individual market.

How do for-profit and not-for-profit health insurers manage capital and surplus? We compare metrics such as the RBC ratio, net income, and growth of capital.

This report provides a detailed analysis of insurer financial results for the U.S. commercial health insurance market, for both individual and group plans.

Commercial payment rates for medical services as percentage of Medicare fee-for-service rates

A patient’s entry point to receive the care they need is shaped by which providers are in their health insurer’s contracted network.

Between 8 million and 24 million people could potentially lose their Medicaid coverage during the 12-month Medicaid eligibility redetermination process....

We estimate the financial impact of the federal requirement for employers and individual insurance plans to cover self-administered and self-read COVID-19 tests.

We examined 15 medical conditions where surgery is an option and discovered a surprising percentage of potentially avoidable procedures. Learn about the cost and care impacts.

What are some best practices in setting out-of-network provider reimbursement levels? How can you achieve cost savings while avoiding unfavorable outcomes? Get answers here.

When confronted with rising costs and shrinking reimbursement, leaders at a hospital in California took a bold step to ensure that they could continue serving the needs of the community in a financially sustainable way.

Read our latest analysis of healthcare costs in the U.S., including prescription drug and employer contribution trends.

See how we’re helping clients reduce costs and improve patient outcomes.