Private Payers News

2024 Payer Strategies: Population-Based Plans, MA Differentiation

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The new year may look remarkably like 2023 from the payer perspective with a similar set of headwinds, but payer strategies may change. Health insurers will build on last year’s progress in...

Humana Awards $169K in Health Equity Grants to Community-Based Orgs

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Humana has granted $169,000 to 24 community-based organizations committed to advancing health equity, according to a press release HealthPayerIntelligence received via email. The payer’s health...

Most Employers Offering Retiree Health Plans Use Medicare Advantage

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Most large employers used to offer retiree health plans, but in 2023, only a fifth of them did, according to a KFF brief. Among those that do, many have turned to Medicare Advantage to supply these...

2022 National Healthcare Spending Growth Slowed to Pre-COVID Levels

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In 2022, national health expenditures hit $4.5 trillion, a 4.1 percent increase, with a couple of key spending areas seeing growth rates return to pre-pandemic levels, CMS announced in a fact...

How Healthcare Leaders Can Weigh Pros, Cons of Payer Megamergers

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When rumors circulate about major payers planning to merge, it always stokes the question: are payer megamergers ultimately good for the healthcare system? When the news broke that Cigna and Humana...

Humana Foundation Grants $1M to Address Food Insecurity, Mental Health

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Humana’s philanthropic arm, the Humana Foundation, has awarded research grants totaling $1 million to three universities that will go toward improving food security and mental health in their...

How Employers Can Promote Cardiovascular Care, Women’s Health

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Cardiovascular, diabetes, and obesity treatments are a critical part of women’s health, and employers can take steps to ensure that women have access to information and care related to their...

Blue Cross Blue Shield of MA Eliminates More Prior Authorizations

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Blue Cross Blue Shield of Massachusetts (“Blue Cross”) joined other payers in eradicating prior authorizations for certain services as part of an effort to accelerate members’ access...

How Much Members Spend on Diabetes Chronic Disease Management

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Members with diabetes spend between $3,300 and $4,600 per year in out-of-pocket costs for chronic disease management, including lost wages, according to a new report from GoodRx Health. These...

What Non-Medical Supplemental Benefits Will MA Plans Offer in 2024?

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Food and produce services are the most common non-medical supplemental benefit in Medicare Advantage for 2024, offered by 1,475 plans, a report from ATI Advisory found. In addition to offering typical...

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...

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...

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...

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...

AMA: Commercial Coverage of Digital Medicine Services is Inconsistent

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Commercial coverage policies for digital medicine Current Procedural Terminology (CPT) codes are inconsistent and lag behind Medicare, an issue brief from the American Medical Association (AMA)...