Payers Expect Biden to Expand Affordable Care Act in 2021
The American Benefits Council (ABC) issued a release outlining what payers should expect legislatively post-election including COVID-19 relief and stimulus legislation, Affordable Care Act expansion,...Medicaid Cuts May Affect Children’s Long-term Health Outcomes
Medicaid cuts to address revenue shortfalls and budget deficits from COVID-19 could result in adverse long-term effects for children, according to an expanding body of research reviewed by The...How Non-Profit Medicare Advantage Plans Can Improve Growth
As for-profit Medicare Advantage health plans rapidly expand across the nation and pick up a large share of the population’s enrollment, non-profit Medicare Advantage plans will have to adjust...How to Rethink Population Health Management for Rare Disease Care
About four and a half years ago, Chris Carlson, senior vice president of customer experience and complex health solutions at UnitedHealth Group, had a significant conversation with his colleague about...CMS Says 8.2M Americans Enrolled on ACA Federal Exchange for 2021
CMS has released preliminary data on the 2021 federal open enrollment season, which saw 8.2 million people select health plans on the Affordable Care Act federal exchange. “Annual enrollment...Ambulatory Surgery Centers Could Save Private Payers $3B
Payers may consider promoting ambulatory surgery centers as the ideal site of care for joint replacement surgeries, UnitedHealth Group’s recent research findings suggested. “Findings from...Private Payer Spending Hits $1.2T in 2019 As Spending Growth Slows
Overall healthcare spending in the US rose 4.6 percent in 2019 to hit $3.8 trillion, with private payers contributing a little more than three out of every ten healthcare dollars (31 percent), a recent...Payer Gross Margins, Medical Loss Ratios Point to a Profitable 2020
Although utilization has started to return to normal levels, payers have continued making a profit during the third quarter of 2020, a Kaiser Family Foundation brief discovered. “In this brief,...Payers Will Improve Virtual Care, Forecasting, Growth in 2021
Payers and stakeholder collaborators have the opportunity to rebuild the healthcare system into a more effective and consumer-centric system in 2021 by honing virtual care and other strategies,...How Payers Can Drive A Quicker Transition to Value-Based Care
Value-based care is a perennial goal for the payer industry, but transitioning into risk-based, outcomes-based contracts has proven to be a slow process. However, Blue Cross and Blue Shield of North...CareFirst Announces COVID-19 Vaccine Coverage for All Members
CareFirst BlueCross BlueShield (CareFirst) has announced that it would offer coronavirus vaccine coverage for all coronavirus vaccines for members, including self-insured members. “The health...Experts Share 5 Pivotal Payer Industry Trends To Watch in 2021
Despite the many unknowns, a diverse group of experts and leaders in the industry have identified five payer industry trends for 2021 that range from strengthening value-based care partnerships to...Humana Announces Value-Based Primary Care Services MA Model
Humana has announced a new value-based primary care services model for Medicare Advantage members using the CMS Primary Care First model. “The creation of this model comes at a critical time....AHIP, BCBSA Call For Federal COVID-19 Relief Funding
As the 116th Congress comes to a close, America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield Association (BCBSA) urged legislators to provide COVID-19 relief, calling for access to...Sponsored by Humana
