This month, Madison Health Group announced it plans to acquire Magellan Health from Centene, roughly five years after Centene bought the company for $2.2 billion. The transaction, pending regulatory approval, would return Magellan to independent ownership under a private equity sponsor amid increased scrutiny of behavioral health...
Nearly 787,000 Arizona beneficiaries began 2026 enrolled in Medicare Advantage (MA), according to CMS January enrollment files — only a modest increase from roughly 780,058 enrollees in June 2025. The muted membership gain suggests growth may be slowing in a national and local market that this year remains flat at about 51%...
Three national insurers delivered earnings this week that, when taken together, sketch a market still adjusting to higher medical cost trends and shifting program economics.
Humana’s update centers squarely on Medicare Advantage (MA). The company reported fourth-quarter revenue of $32.5 billion and full-year revenue of $129.7...Arizona News
Arizona Complete Health, a subsidiary of Centene and one of Arizona’s largest AHCCCS insurers, has awarded $950,000 in capital grants to 32 nonprofit and public-sector organizations statewide.
According to the insurer, the grants are intended to strengthen community infrastructure supporting healthcare access, housing stability,...Arizona News
The Arizona Health Care Cost Containment System (AHCCCS) last week terminated its December 2023 ALTCS-EPD contract awards, resetting a procurement process that has been contested for nearly two years.
AHCCCS said it will issue a new request for proposals for the ALTCS-EPD program, with submissions expected in fall 2026.
Mercy Care,...Arizona News
AHCCCS said members in its Arizona Long Term Care System for the elderly and physically disabled will remain with Banner, Mercy Care and UnitedHealthcare plans for another year after the agency extended existing contracts through Sept. 30, 2026.
New ALTCS EPD contracts were set to begin Oct. 1, 2025 with Mercy Care, Banner–University...
This analysis of Arizona Rate Review Submissions by The Hertel Report only includes filing by returning Arizona Marketplace insurers, which offers insight into expected premium costs and the drivers of expected increases for 2026 Arizona plans marketed on HealthCare.gov
Arizona rate review submissions to the Arizona Department of...
Get the latest on national and Arizona Medicare Advantage (MA) enrollment in The Hertel Report's annual MA Data Edition. Learn about Arizona's top-performing MA plans, enrollment leaders, MA market penetration, and our popular MA enrollment by Arizona county and more!
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Several insurers lowered investors' expectations after an underwhelming second quarter. Financial analysts have noted that fiscal setbacks are rapidly becoming endemic to the health insurance sector.
On Tuesday, UnitedHealth Group revised its financial projections for the remainder of the year and will now project less than half of...Arizona News
On June 20, 2025, the Maricopa County Superior Court stayed AHCCCS’ decision to award ALTCS EPD contracts to Centene and UnitedHealthcare, along with its subsequent decision to expand those awards to Mercy Care and Banner–University Family Care. The Court made clear that even contracts resulting from settlement agreements cannot move...National News
Centene threw out its earnings guidance for the year after projections showed that the company will make $1.8 billion less than expected through the exchange risk-adjustment program.
In a news release on Tuesday, Centene announced that a report by the independent actuarial firm Wakely found that 22 of the company's 29 Marketplace...
Inaccurate provider directories, also called "ghost networks," are the subject of two recent lawsuits against health insurers.
Last year, ProPublica reported on the death of Ravi Coutinho after he was unable to find adequate mental health and addiction treatment in Phoenix that was covered by the health insurance plan he purchased...
The Centers for Medicare & Medicaid Services (CMS) conducts Risk Adjustment Data Validation (RADV) audits to ensure diagnoses used to determine Medicare Advantage (MA) payments are backed by medical records; federal estimates suggest MA plans may overbill the government between $17 to $43 billion a year. The agency now pledges to...
Beginning October 1, 2025, Banner Health and Mercy Care will join Centene and UnitedHealthcare to provide covered services for about 26,000 Arizonans enrolled in its Arizona Long Term Care System (ALTCS) Elderly and/or Physically Disabled (EPD) program. Statewide contracts were awarded to Centene and UHC but Banner Health and Mercy Care...National News
Superior HealthPlan CEO Mark Sanders was dismissed hours after Texas Attorney General Ken Paxton opened an investigation into the insurer’s alleged surveillance of state lawmakers and others. The abrupt leadership change comes as parent company Centene faces mounting scrutiny, including a recent Wall Street Journal report that found it...National News
Health Net Federal Services Inc. (HNFS) and its corporate parent Centene allegedly falsely certified compliance with cybersecurity requirements in a contract with the U.S. Department of Defense (DoD) to administer the Defense Health Agency’s (DHA) TRICARE health benefits program for service members and their families.
In 2016,...Arizona News
With about 28.6 million members, including 12 million Medicaid lives, 4.4 million Marketplace members, and 4.8 million commercial enrollees, Centene beat its 2023 numbers; $2.7 billion in profit and $154 billion in revenue.
The insurer's biggest pocket of business is Medicaid; $84 billion in premium and service revenue in 2024....
With normal communications from CMS suspended, no January 2025 enrollment totals are available. Instead, The Hertel Report compiled end-of-year (EOY) Arizona Medicare Advantage enrollment totals and market penetration, as well as the agency's December 2024 dump of monetary sanctions against Elevance, Centene, and Humana, including plans...
Anthem Blue Cross Blue Shield of New York, a subsidiary of Elevance Health, faces a proposed class action from policyholders accusing the insurer of listing out-of-network providers, especially for mental healthcare, in its directories. These so-called "ghost networks" deter patients from accessing care, inflate costs, and create...
The National Association of Insurance Commissioners report provides financial and market intelligence on the insurance industry - another tool for insurers to identify their competitors and comparative market share. The Hertel Report collected the top 10 leaders in Arizona including UnitedHealth Group, Blue Cross Blue Shield of Arizona...
