Private Payers News

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

by

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...

Anthem Blue Cross Grants $400K to Boost Maternal Health Outcomes

by

The Anthem Blue Cross Foundation has granted $400,000 to a nonprofit organization in Fresno County, California, to help improve maternal health outcomes and reduce pre-term births among women who have...

Payer Invests in Helping Young Adults Find Work After Foster Care

by

Blue Cross of North Carolina (Blue Cross NC) announced a program that focuses on supporting children who are aging out of foster care through employment. “Our Apprenticeship Program provides...

22% of Employers Waver on Adhering to ACA Preventive Care Rules

by

The coronavirus pandemic brought underscored the role of preventive care services in employee health, but in light of recent litigation, 28 percent of employers were either unsure of whether they would...

CA Health Plans Commit $114M to Address Homelessness, Health Equity

by

LA Care Health Plan and Health Net have committed to investing $114 million over five years to address homelessness and improve health equity in Los Angeles County. The health plans have collaborated...

Humana Seeks to Improve Medicare Advantage Specialty Needs Benefits

by

Humana has announced a partnership with Longevity Health Plan to improve Medicare Advantage members’ specialty needs plan benefits. Humana’s partner is both a clinical services company and...

UHC Grants $275K to Address Social Determinants of Health for Foster Kids

by

UnitedHealthcare Community Plan of North Carolina is granting $275,000 to three local organizations to help address social determinants of health for children in kinship and foster care. “Caring...

UnitedHealthcare Pays $91.2M After Underpaying Envision for Medical Care

by

After underpaying the medical group for essential care, UnitedHealthcare has been ordered to pay $91.2 million to Envision Healthcare (Envision). An independent three-member panel of the American...

Higher Market Share Helps Payers in Negotiations, Premium Impact Unclear

by

Payers with larger market shares tend to have lower prices nationally, a study published in Health Affairs confirmed. The researchers used data from Turquoise Health, a company that collects hospital...

Payers Fall Short of Employer Expectations on Behavioral Healthcare

by

Employers agree that behavioral healthcare is a critical element of employer-sponsored health plan benefits, but more than three in ten found their payer’s behavioral healthcare benefits...

Anthem, Valley Health Resolve Lawsuit Over Past-Due Payments

by

Regional health system Valley Health has reached a settlement agreement with Anthem Blue Cross and Blue Shield, resolving a dispute over past-due payments for healthcare claims, according to a press...

Humana Funds UNF Program Expansion to Address Food Insecurity

by

Humana has partnered with an academic institution to expand a program that assists seniors with food insecurity challenges. Meals on Wings is a program at the University of Northern Florida (UNF),...

83% of Consumers Are Interested in Health Savings Accounts for Non-HDHPs

by

Many consumers would be interested in a type of account that was like a health savings account (HSA) in its construction but able to be attached to plans other than high deductible health plans...

Coverage Gaps, Uninsurance Tied to Unmet Vision Care Needs

by

Health insurance coverage gaps and uninsurance were associated with a higher risk of unmet vision care needs among adults in Ohio, indicating the importance of continuous coverage, a study published in...

Humana Continues to Address Housing Stability with $40M Investment

by

Humana is investing $40 million in affordable housing development, furthering its national commitment to improve housing stability for health plan members. This round of funding brings the...

Employees Turn to Health Savings Accounts to Manage Healthcare Costs

by

Employees—particularly in younger generations—are investing in health savings accounts to manage their healthcare spending and find their employer-sponsored health plans are not enough to...

Aetna Offers Virtual Care Tool for Gastrointestinal Chronic Diseases

by

Aetna launched a partnership with a virtual care company to provide chronic disease management for members with digestive issues. Aetna’s partner offers a virtual care platform dedicated to...

How 2023 Medicare Advantage Enrollment Growth Has Shifted

by

This article was originally published on 2/22/23. It has been updated to reflect corrected data from Chartis and CMS. Medicare Advantage enrollment has increased by 2.7 million beneficiaries in 2023...

Out-of-Pocket Spending for Pediatric Hospitalizations Reached $3,000

by

The average out-of-pocket spending per non-birth-related pediatric hospitalization was $1,313 for privately insured children, but spending varied depending on the time of the year, chronic condition...

Study Finds Racial Coverage Disparities Following Unemployment

by

After becoming unemployed during the COVID-19 pandemic, Medicaid coverage gains helped offset private insurance losses for White individuals but not for Black and Hispanic individuals, highlighting...