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Payers Embrace Healthcare IT for Cost Optimization, Member Engagement

December 4, 2023 - Payers are investing in healthcare IT resources to support cost optimization and improve member experience, according to a study from EY-Parthenon and KLAS Research. As payers face operational and financial pressures, they are turning to healthcare IT solutions for help. Researchers sought to understand what strategies payers prioritize, how much...


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KLAS: Epic’s Payer Platform Generates High User Satisfaction

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Healthcare organizations using Epic’s payer platform are satisfied with the product’s performance, including its ability to deliver meaningful information without disrupting workflows,...

HHS Attributes Record Low Uninsurance Rate to ACA Enrollment

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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...

Judge Rules That Employers Do Not Have to Cover Certain Preventive Care Services

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A US district judge ruled in Braidwood Management vs Becerra that employers do not have to cover preventive care services based on recommendations from US Preventive Services Task Force (USPSTF). Six...

Uninsurance Rate Drops to Record Low of 8%, Pointing to ACA Enrollment Boom

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The national uninsurance rate has dropped to eight percent, a record-breaking low for the US, according to data from the Assistant Secretary for Planning and Evaluation’s Office of Health Policy...

Payers Respond to SCOTUS Overturning Abortion Rights Case

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Updated 6/28/2022: This article has been updated to include statements from the Association for Community Affiliated Plans (ACAP), Robert Wood Johnson Foundation, and the American...

Walmart Launches Provider Recommendation Tool for Health Plan Members

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Walmart has partnered with a healthcare machine intelligence company to offer a personalized provider recommendation tool to associates who receive healthcare coverage through the retail giant’s...

Record-Breaking ACA Open Enrollment Gains 5.8M New Enrollees

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CMS and HHS have announced that the Affordable Care Act marketplace gained 5.8 million new enrollees in the 2022 open enrollment season, contributing to a record-breaking 14.5 million...

Change Healthcare May Sell Assets to Prepare for UHG Merger

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Change Healthcare is considering selling its payment integrity business, ClaimsXten, to prepare for its upcoming merger with UnitedHealth Group. ClaimsXten is a payment solution that aims to help...

Medicaid Will Cover Coronavirus Vaccine Counseling for Kids

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State Medicaid programs must cover coronavirus vaccine counseling for children as well as vaccine counseling for all pediatric vaccines for eligible beneficiaries, CMS announced. “By supporting...

Walmart Increases Self-Funded Employer Access to Cost-Effective Care

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Walmart has partnered with a digital platform to provide self-funded employers and their employees with access to cost-effective healthcare. Employers across the country will be able to utilize...

JPMorgan Chase Reveals Employer-Sponsored Health Plan Goals

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JPMorgan Chase has launched its new healthcare business unit, Morgan Health, which will aim to improve employer-sponsored health plan benefits among other goals. The employer will invest $250 million...

CMS Finalizes Second 2022 Payment Notice with Cost-Sharing Limits

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The second 2022 Notice of Benefit and Payment Parameters final rule (“2022 payment notice”) finalized changes that made cost-sharing limits $400 lower than what CMS had proposed in...

HHS Will Spend $50M on Outreach for Special Enrollment Period

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The US Department of Health and Human Services (HHS) and CMS announced that the Biden Administration would spend $50 million to advertise the special enrollment period. “We’re...

Perpetrators of National ACA Enrollment Fraud Case Sentenced

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Update 3/3/2021: This article has been updated to reflect that Jeffrey Yates was indicted as having participated in the Whites' fraud scheme. A previous version said that he was...

White House Sets Up Federal Marketplace Special Enrollment Period

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The Biden administration has signed an executive order that sought to strengthen Medicaid and Affordable Care Act marketplace coverage and opened a special enrollment period on the Affordable Care...

Biden Selects CMS Official as Temporary, Acting CMS Administrator

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The Biden administration has chosen Liz Richter, the Deputy Center Director of CMS, to be acting CMS Administrator while the new president chooses an official appointee for the role. As the...

ACA Federal Marketplace Sees 7% Enrollment Increase in 2021

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CMS has released its final snapshot for Affordable Care Act enrollment on the federal platform for the 2021 open enrollment period. This year’s open enrollment was unique in part due to the...

UnitedHealth Group Plans to Acquire Change Healthcare in 2021

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UnitedHealth Group has announced that its diversified health services company, Optum, and Change Healthcare will combine. The deal will be worth approximately $8 billion, YahooFinance...

Joint Venture To Lower Employee Healthcare Costs, Haven, Disbands

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Haven, the joint venture healthcare company between three of America’s most powerful firms is disbanding after three years, according to CNBC. The partnership between Amazon, JPMorgan Chase, and...