HealthPayerIntelligence News

Care Quality, Health Outcomes Better in Medicare Advantage than FFS

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Medicare Advantage beneficiaries experience higher quality care and better health outcomes than fee-for-service beneficiaries, according to a report from Harvard and Inovalon. Researchers used...

7 Elements of Successful Community Health Worker Integration

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Medicaid programs are leveraging community health workers (CHWs) to improve patient navigation, quality of care, and cultural competency, a Manatt Health newsletter found. “The use of CHWs...

9 Trends To Watch During ACA Marketplace 2024 Open Enrollment

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Going into the 2024 open enrollment season, healthcare stakeholders should be prepared for nine key trends in Affordable Care Act marketplace enrollment, according to experts from KFF. First,...

Study Finds Geographic Variation in Payer Prices for Office Visits

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Among a single health insurer, prices for office visits varied by geographic location, with the upper-Midwest and Southeast regions seeing higher costs, a study published in JAMA Health Forum...

Finances, Mental Health Concerns Impact Adults’ Wellbeing, Cigna Finds

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Americans are feeling more optimistic about their wellbeing than last year, but financial concerns and mental health challenges are still negatively impacting their health, according to a report from...

3 Steps One Medicaid MCO Took to Boost Its Patient Experience Score

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Ease and efficiency in access to care contribute to the patient experience measurement in the National Committee on Quality Assurance’s (NCQA) Health Plan Report Card for Medicaid managed care...

Humana Ranks High for Experience, Affordability Among MA Plans

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Based on the 2024 Medicare Advantage star ratings, Humana received the highest ranking for overall plan quality, member experience, and low premiums, a US News & World Report analysis shared. The...

Employer Sponsored Health Insurance Premiums Grew by 7% in 2023

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The average annual premium for employer-sponsored health insurance increased by 7 percent in 2023, a KFF survey revealed. The 2023 benchmark KFF Employer Health Benefits Survey included interviews...

HHS Patient Assistance Program Aims To Boost Access to COVID-19 Drug

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The Department of Health and Human Services (HHS) will ensure access to a coronavirus therapy from Pfizer for Medicare and Medicaid beneficiaries and the uninsured through a patient assistance program,...

Medicare Advantage Star Ratings Fall for Second Consecutive Year

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The average star ratings for Medicare Advantage and Medicare Part D prescription drug plans fell for the second year in a row to 4.04 and 3.11 stars, respectively, CMS data revealed. The star rating...

Medicare Part B Premiums, Deductibles Will Increase in 2024

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Monthly Medicare Part B premiums will increase by nearly $10 in 2024 due to a projected increase in healthcare spending, CMS announced. Medicare Part B covers physician services, outpatient hospital...

Who is Challenging the Medicare Drug Price Negotiation Rule?

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The Medicare drug price negotiation provisions in the Inflation Reduction Act hold promising spending reductions for beneficiaries, but drug companies are not backing down without a fight. In August...

Does Medicaid Managed Care Impact Specialty Care Access for Kids?

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Medicaid managed care enrollment was not associated with poorer specialty care access for children with special healthcare needs, but it was tied to greater caregiver frustration and reduced mental...

What Are Major Payers Offering Medicare Advantage Members in 2024?

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As Medicare’s open enrollment period approaches, payers have announced new Medicare Advantage plan offerings for 2024.   Because Medicare Advantage plans receive flexibility to cover...

UHC Commercial Plan Focuses on Price Transparency, Preventive Care

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UnitedHealthcare’s Affordable Care Act-compliant employer-sponsored health plan, Surest, is the payer’s fastest-growing commercial plan. Data indicates that Surest’s emphasis on price...

Medicaid Expansion Improved Health Equity for Redlined Areas

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In historically redlined areas, states that adopted Medicaid expansion saw lower uninsurance rates than nonexpansion states, a study published in Health Affairs uncovered. Redlined areas were...

Mortality Rates Among Women and Children Are Rising, UHG Report Finds

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Mortality rates among women and children grew between 2018 and 2021, emphasizing the importance of prioritizing preventive care and public health interventions, a report from the United Health...

CMS Orders States to Provide Continuous Coverage for Kids in Medicaid, CHIP

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CMS is reminding state health officials of the upcoming continuous coverage requirements for children in Medicaid and the Children’s Health Insurance Program (CHIP). Provisions in the...

Alignment Health to Offer Medicare Advantage Plans That Address SDOH

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Alignment Healthcare has partnered with Instacart to offer Medicare Advantage plans in 2024 that address social determinants of health, including food insecurity and transportation access. “Our...