MVP Health Care will no longer offer its co-branded Medicare Advantage plan with the University of Vermont Health Network in its home state for the 2025 plan year. “The current MA model is no longer sustainable in Vermont, given sharply increasing post-pandemic surges in care utilization and difficult regulatory changes on the horizon in 2025,” MVP said in a statement. The plan will still be available in five New York counties, however. The UVM plan currently serves 6,343 members in Vermont. Overall, the insurer enrolls 259,687 MA members.

Gold Kidney Health Plan last week said it is undertaking a significant expansion of its Medicare Advantage offerings in Florida and Arizona for 2025. The company will increase its presence from 9 to 22 counties in Florida and from 4 to 8 markets in Arizona, aiming to provide more Medicare-eligible residents with access to high-quality, affordable health coverage. This expansion includes services for individuals with chronic conditions such as end-stage renal disease, diabetes and heart failure. The insurer currently serves 1,067 members in its specialized MA products.

Priority Health this week unveiled a partnership with Carrot Fertility to provide comprehensive reproductive health support to its Michigan members. This collaboration will offer two tailored solutions, Carrot Core and Carrot Pro, addressing a wide range of needs from fertility treatments to menopause and hormonal health. The initiative aims to deliver personalized care and expert guidance, enhancing access to reproductive health services and supporting various family-planning journeys. The new offerings will be available to both fully funded and self-funded employer groups starting January 1, 2025. Priority Health currently serves 418,909 risk-based employer group members and 90,339 self-funded members.

Cigna Healthcare has plans to reduce its Medicare Advantage offerings in eight states starting in 2025, impacting approximately 5,400 members, primarily in Florida. The insurer will cut 36 plans and exit at least three counties entirely, citing the need to maintain profitability amid rising healthcare costs and regulatory changes, according to an announcement posted on Pinnacle Financial Services’ website. Despite these reductions, most affected members will still have access to other Cigna MA plans in their areas. Cigna is in the process of selling its MA business to Blues giant Health Care Service Corp. Cigna currently serves 577,930 MA and dual eligible members nationwide.

Highmark Blue Shield is poised to expand its Medicare Advantage footprint in Pennsylvania with the launch of plans in the greater Philadelphia area, reports the Philadelphia Business Journal. Highmark Health, the Pittsburgh-based not-for-profit parent company of Highmark Blue Shield and other Blue Cross Blue Shield plans, on Aug. 29 reported an 8% year-over-year increase in revenue that it largely attributed to the Highmark Health Plans business. For the first half of 2024, that segment posted operating revenue of $11.1 billion and an operating gain of $304 million, “driven by steady membership in both government and commercial business,” the insurer said. Highmark is the second-largest MA insurer in Pennsylvania, behind CVS Health Corp.’s Aetna, with 283,134 members.

Eli Lilly’s immunology unit nabbed its third FDA approval with the Sept. 13 green light for Ebglyss (lebrikizumab), an IL-13 inhibitor designed to treat moderate-to-severe atopic dermatitis in patients aged 12 and older. The biologic targets and blocks IL-13, a protein associated with the inflammation that drives eczema, offering a new treatment option for patients who haven’t found relief with topical prescriptions. Ebglyss will have to face off against Sanofi and Regeneron’s Dupixent, which targets both IL-13 and IL-14, and LEO Pharma’s Adbry, a fellow IL-13 inhibitor. For the treatment of atopic dermatitis, Dupixent holds preferred status for 50% of all insured lives under the pharmacy benefit, to Adbry’s 38%. Both drugs typically require utilization management. But Ebglyss’ once-monthly maintenance dosing could prove more convenient for patients — Dupixent and Adbry are typically administered every other week.

The FDA on Sept. 5 granted full approval to Travere Therapeutics, Inc.’s Filspari (sparsentan) to slow kidney function decline in adults with primary IgAN who are at risk for disease progression. The agency gave the endothelin and angiotensin II receptor antagonist accelerated approval on Feb. 17, 2023, based on the surrogate marker of proteinuria. Dosing of the tablet starts at 200 mg once daily; after 14 days, dosing increases to 400 mg once daily. Drugs.com lists the price of 30 tablet of both the 200 mg and 400 mg strengths as more than $11,257. Filspari currently holds covered or better status for 74% of all insured lives under the pharmacy benefit, largely with utilization management restrictions applied.

Cigna Healthcare is launching a new “E-Treatment” option through MDLIVE by Evernorth, making virtual care more accessible and convenient for customers who have coverage through the individual marketplace or via their employer. The service allows users to receive diagnoses and treatment plans for common, lower-risk conditions such as allergies, infections, and respiratory illnesses without direct interaction via phone or video.

Elevance Health, Inc. has agreed to acquire Indiana University Health Plans, according to a Sept. 10 press release. IU Health Plans, a subsidiary of Indiana University Health, has 19,245 Medicare Advantage members and 10,868 fully insured commercial beneficiaries. It will become a part of Anthem Blue Cross and Blue Shield in Indiana, which is Elevance’s insurance affiliate in the state. The deal is subject to customary closing conditions and is expected to close by the end of the year.

Cigna CEO David Cordani has warned of “choppiness” in the coverage of GLP-1 drugs, which are used for weight loss and diabetes management, due to their high costs. Speaking at Morgan Stanley's annual Global Healthcare Conference, Cordani highlighted the challenges of balancing expanded access with affordability.