Millions of Medicaid enrollees have been disenrolled from Medicaid during the redetermination process, largely for procedural reasons, a KFF tracker noted.
As of August 23, 2023, over 5.36 million...
Medicare Advantage plans received generally positive satisfaction scores, with beneficiaries giving high ratings on trust, ease of doing business, and meeting product and coverage needs, according to a...
CMS has released draft guidance detailing a new program allowing Medicare beneficiaries to pay out-of-pocket Part D costs in monthly installments.
The Medicare Prescription Payment Plan is required...
Insurers often negotiate hospital prices for their commercial health plans that are up to five times the Medicare Advantage price, a study published in Health Affairs found.
It was already a...
As obesity treatments become more popular, Medicaid plays a key role in facilitating access to and coverage of these services for children, according to a KFF issue brief.
Obesity can increase the...
Core Quality Measures Collaborative (CQMC) released new core quality measures and the implementation guidelines for certain core sets.
More than 75 healthcare organizations, including payers,...
Blue Shield of California (Blue Shield) has launched a value-based pharmacy model to improve member access to affordable prescription drugs.
The payer has partnered with five companies to deploy the...
Reducing drug prices is top-of-mind for payers and employers alike. Some payers, like Capital Blue Cross, seek to make drugs more affordable by connecting members with existing coupon...
Payers prefer to utilize claims and administration platforms from vendors that are efficient, manage multiple business lines, and can meet their complex needs, according to a KLAS report.
The Payer...
Although prior authorization aims to control costs and limit unnecessary medical procedures, healthcare stakeholders have continued to raise concerns that the process creates substantial administrative...
Blue Cross of Idaho and several venture capital firms have invested in Endear Health, a digital platform that aims to improve value-based care delivery for Medicare Advantage beneficiaries.
The...
Even as inflation seems to be plunging from its peak, the ongoing pressure from high medical costs is set to push ACA Marketplace premiums up to an average of 6 percent in 2024, according to...
Following the Affordable Care Act (ACA) open enrollment period that concluded in January 2023, the United States Department of Health and Human Services (HHS) reported that uninsurance among American...
The provisions of the No Surprises Act rule that detail the independent dispute resolution (IDR) process for out-of-network claims have been making waves in the healthcare space.
The No Surprises Act...
Medicare Part D premiums are projected to decrease from $56.49 in 2023 to $55.50 in 2024, CMS announced.
The projected average Part D premium represents the sum of the average basic premium and the...
Individuals were more likely to receive breast cancer and colorectal cancer screenings after obtaining Medicare coverage, according to a study from Epic Research.
The Affordable Care Act requires...
AHIP joined the American Hospital Association (AHA), American Medical Association (AMA), and Blue Cross Blue Shield Association (BCBSA) in opposing the prior authorization reformation efforts from CMS...
Veterans’ lack of awareness about their potential benefits under the Promise to Address Comprehensive Toxics Act (PACT Act) could lead to significant financial losses due to healthcare...
Almost four months after the Medicaid continuous enrollment provision ended, CMS has paused coverage redeterminations in at least six states.
In a press call on July 19, CMS Administrator Chiquita...
The Biden-Harris Administration has proposed a rule to improve access to mental healthcare for privately insured Americans by establishing mental health parity requirements.
The rule supports the...
