Private Payers News

BCBSA Will Invest $10M to Address Youth Mental Health Crisis

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The Blue Cross Blue Shield Association (BCBSA) has partnered with Boys & Girls Clubs of America to address the youth mental health crisis by increasing access to trauma-informed care. “The...

Blue Cross MN Commercial Plans Will Cover Peer Support Specialists

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Blue Cross and Blue Shield of Minnesota (Blue Cross) is improving member access to mental health resources by adding coverage of peer support specialists to commercial plans next year. “As the...

KFF: Over Half of Insured Adults Face Problems with Health Insurance

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More than half of adults experienced problems with their health insurance, with issues ranging from payment discrepancies to limited mental healthcare coverage, a KFF survey found. The survey was...

SCAN, CareOregon Grants Help Eliminate $110M in Medical Debt

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SCAN and CareOregon have granted $345,000 to a nonprofit organization that helps eliminate medical debt, a move expected to erase $110 million in debt for residents across five states. RIP Medical...

BCBSTX Provider Network Expansion Improves Behavioral Healthcare Access

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Blue Cross and Blue Shield of Texas (BCBSTX) is improving behavioral healthcare access for members with an expanded provider network and additional telehealth offerings. After the payer expanded its...

5 Chronic Diseases Plague High Spending Group Health Plan Members

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Group health insurance plan members with high healthcare spending often have one or more of the same five chronic diseases, according to a fast facts sheet from the EBRI Center for Research on Health...

Coverage Rates Equalize For LGBT Community, But Disparities Remain

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Coverage rates in the LGBT community have improved since the Affordable Care Act went into effect and the Supreme Court ruled on marriage equality, but access to care barriers remain, according to a...

Blue Cross MA Expands Mental Health Resources, Provider Network

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Blue Cross Blue Shield of Massachusetts (Blue Cross) continues to expand mental health resources for members, as spending on mental health services totaled over $1 billion in 2022. Since the start of...

NY Health Plan Helps Members Navigate Health Insurance Renewals

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New York-based health plan Healthfirst has launched a campaign to help members navigate health insurance renewals in a post-public health emergency (PHE) world. During the COVID-19 PHE, Healthfirst...

Medicare Advantage Risk Adjustment Model Accuracy May Vary By Race

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The CMS-Hierarchical Condition Category (HCC) model used for Medicare Advantage risk adjustment may inaccurately estimate beneficiaries’ spending depending on the race or ethnicity of the...

Type 2 Diabetes Patients Benefit from Capital Blue Cross Program

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After engaging in a free program provided by Capital Blue Cross (Capital), type 2 diabetes patients experienced a variety of health improvements along with noticeable financial benefits, according to a...

AHIP: Most Consumers Are Satisfied with Employer-Provided Coverage

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Conducted by LSG on behalf of America’s Health Insurance Plans (AHIP), a survey on the opinions of US consumers in 2023 found that many prefer to receive coverage from their employer rather than...

Loss of ACA Preventive Care Mandate Could Impact 10M Enrollees

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With the Affordable Care Act’s preventive care coverage requirement under scrutiny, Peterson-KFF researchers investigated how many Americans rely on the law’s coverage and determined that...

Aetna Awards $250K in Social Determinants of Health Grants in MI

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Aetna’s Medicaid plan in Michigan has granted $250,000 to 10 community-based organizations, aiming to address social determinants of health (SDOH) needs and advance health equity throughout the...

Healthcare Organizations Oppose UHC’s GI Prior Authorization Program

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More than 170 healthcare organizations have urged UnitedHealthcare not to implement its gastrointestinal (GI) endoscopy prior authorization program, stating that it will hurt patients and limit access...

Aetna Injects $7.3M into Virginia FQHCs for Improved Cancer Outcomes

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In partnership with the Virginia Community Healthcare Association (VCHA), Aetna Better Health of Virginia has allocated over $7 million in value-based care incentives to Virginia's federally...

KFF: Payers Will Issue $1.1B in Medical Loss Ratio Rebates in 2023

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Payers will issue around $1.1 billion in medical loss ratio (MLR) rebates across commercial markets in 2023, KFF projected. In the individual and small group markets, payers must spend at least...

Blue Cross MA Expands Primary Care Network Amid Provider Shortages

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Blue Cross Blue Shield of Massachusetts (Blue Cross) has added three physician groups to its primary care network to increase member access to care amid provider shortages. Most Blue Cross members...

CareSource Enters Value-Based Agreement to Improve Pediatric Health Outcomes

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CareSource has entered into a value-based agreement with a clinically integrated network to improve pediatric health outcomes for Georgians. The partnership between the health plan and The...

Humana Collabs with DME Companies to Advance Value-Based Home Healthcare

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Humana has entered value-based agreements with two durable medical equipment organizations to improve home healthcare services for Medicare Advantage members. The organizations, AdaptHealth Corp. and...