Cambia Health Solutions (Cambia) and Blue Cross Blue Shield of North Dakota (BCBSND) announced a strategic affiliation, making BCBSND the newest single-state Blue plan to affiliate with Cambia. The affiliation will unify operations and enable the organizations to share best practices for local plan innovation and services, deliver personalized member experiences, and leverage Cambia’s robust…

On September 9, 2025, the Centers for Medicare & Medicaid Services (CMS) issued preliminary guidance to states on implementing new federal payment limits for state-directed payments (SDPs) in Medicaid managed care. SDPs enable states to direct Medicaid managed care organizations (MCOs) and other managed care entities to pay higher reimbursement rates to some provider organization…

In 2025, 11 health plans received a 5-star rating from the National Committee for Quality Assurance (NCQA), and another 55 plans received a 4.5-star rating in the annual health plan rating report. The ratings are based on the plan’s delivery of high-quality care, excellent clinical results, strong member satisfaction, and improved health outcomes. In 2024,…

Priority Health, a nationally recognized nonprofit health plan serving more than 1.3 million members, has added Boulder Care, a high-quality value-based telehealth addiction medicine provider organization, to its extensive provider network as part of its ongoing effort to expand its behavioral health network and support services, according to a recent announcement. Benefits include access to…

Innovaccer Inc., a health care artificial intelligence (AI) company, announced that it acquired Story Health, a pioneering AI-powered, tech-enabled cardiovascular care platform focused on transforming specialty care from episodic to continuous, digital models. This acquisition builds on Innovaccer’s strategic acquisitions including Humbi AI, Cured, and Pharmacy Quality Solutions, extending its Healthcare Intelligence Cloud into agentic…

Bespoke Concierge MD, a leader in precision and concierge medicine, announced the launch of its new Corporate Health Plans—an employer-based model designed to bring proactive health care into the workplace and help companies better protect and support the health of their workforce. The new plans provide employees with direct physician access, proactive monthly checkups, and…

Magellan Health, Inc., announced that pediatric primary care provider organizations that integrate its collaborative care model (CoCM) directly into their care setting reduce barriers to access, improve provider organization satisfaction, and deliver measurable results to children and their families. The evidence-based CoCMA’s integrated approach to health care is demonstrated to enhance consumer outcomes, and has…

Bayvrio, which offers advanced technology and innovative, curated solutions to health care payers, announced the launch of the Bayvrio Marketplace, a first-of-its-kind model that will change the way the industry builds, manages, and delivers health care and pharmacy benefits. By giving pharmacy benefit managers (PBMs), health plans, and health systems the freedom to choose from…

The federal budget reconciliation bill, House Resolution (HR) 1, which was signed into law on July 4, 2025, includes provisions that affect Affordable Care Act (ACA) health Insurance Marketplace plans, according to an analysis by KFF, a non-profit organization focused on health policy. Pre-enrollment verification processes, documentation requirements, a shorter open enrollment period ending on…