UPMC Health Plan and Sempre Health’s medication adherence collaboration has expanded its chronic disease management benefits to include diabetes medicines for members of UPMC’s...
Over the last couple of years, Medicare Advantage supplemental benefits have seen a great deal of reinterpretation that has led to their expansion and evolution, a Milliman brief commissioned by Better...
Coronavirus vaccine coverage is a complex subject, as it spans multiple patient populations that typically receive vaccine coverage in different ways, a Kaiser Family Foundation brief elucidated.
As...
Employers called for healthcare price regulation and transparency to ensure employer-sponsored health plan affordability in the annual Pulse of the Purchaser survey conducted by the National Alliance...
Kaiser Foundation Health Plan of Washington will pay over $6.3 million for submitting invalid Medicare Advantage diagnoses, according to the Department of Justice (DOJ).
“When insurance...
States that did not opt into Medicaid expansion under the Affordable Care Act (ACA) experienced worse emergency access to acute care hospitals compared to states that did, according to recent...
Aetna’s new partnership leverages the pharmacist-patient relationship to improve Aetna’s Medicaid member engagement and better address social determinants of health, CVS Health announced...
The Government Accountability Office (GAO) has released a report finding high market concentration across the payer industry and that having increased health plan options does not necessarily reduce...
The coronavirus pandemic has highlighted many of the problems in the healthcare system including the practice of price gouging, according to a recent America’s Health Insurance Plans (AHIP)...
The individual health insurance market’s premiums mostly go towards highly utilized services, a Robert Wood Johnson study discovered.
“The requirement that these essential benefits be...
States can use Medicaid expansion and additional Medicaid policies—such as beginning Medicaid eligibility determinations pre-release and suspending Medicaid coverage during incarceration—to...
As the Supreme Court deliberates the fate of the Affordable Care Act after hearing the oral arguments, payers and the public alike are processing the court case and its implications for the healthcare...
Centene Corporation has signed a definitive agreement to acquire Apixio Inc., a healthcare analytics company that offers artificial intelligence (AI) technology solutions, in a move the payer said will...
CMS announced that Medicare coverage will now extend to monoclonal antibodies for coronavirus treatment in certain cases.
Monoclonal antibodies are lab-constructed antibodies, the National Institute...
Payers’ top coronavirus-related concern is the effectiveness of a coronavirus vaccine, Avalere researchers have discovered.
The Avalere researchers deployed an online survey and received...
In the San Francisco Bay Area, employers face the challenge of escalating healthcare spending.
This problem is not restricted to the Bay Area alone. Average premiums nationwide were around $7,470 for...
McLaren St. Luke’s has filed an anti-trust lawsuit against ProMedica Health System to prevent it from retracting Paramount commercial and Medicare Advantage health plan coverage.
According to...
If beneficiaries were to choose the same health plan for 2021 as they did for 2020, slightly over 19 percent of Medicare Advantage beneficiaries would be enrolled in plans with a 4.5 Medicare Advantage...
After losing their employer-sponsored health plans, many adults are shifting to public and non-group plans, emphasizing the important role that the Affordable Care Act plays in health insurance, an...
Poor maternal and infant care access can have deadly implications for new mothers and their babies, but Medicaid expansion efforts can improve three key prenatal and postpartum health indicators, a...
