HealthPayerIntelligence News

Stakeholder Groups Oppose Medicare Advantage Risk Adjustment Changes

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Since CMS released the 2024 Medicare Advantage Advance Notice in February, healthcare stakeholders have not been silent about their concerns with the proposed risk adjustment model changes. CMS...

Feds Share Details on Inflation Rebates for Medicare Prescription Drugs

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The Department of Health and Human Services (HHS) and CMS have lowered prices for over two dozen Medicare prescription drugs including biologics for a set timeframe. Starting on April 1, 2023,...

BCBSRI Recognizes Healthcare Sites Providing LGBTQ-Inclusive Care

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Blue Cross & Blue Shield of Rhode Island has recognized 10 healthcare sites that provide inclusive care tailored to meet the needs of the LGBTQ community. The recognition comes in the form of an...

Americans Who Lose Medicaid Post-PHE May Choose Employer-Sponsored Coverage

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In most states, beneficiaries who lose Medicaid coverage when the public health emergency ends are likely to transition into employer-sponsored health plans, according to a study funded by AHIP from...

CA VBID Program Boosted Primary Care Use, Contained Healthcare Costs

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California’s value-based insurance design (VBID) program was associated with a higher probability of primary care use, a lower probability of inpatient admissions, and no change in total costs...

Humana Shares Data on Economic Contributions in Florida

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Throughout 2022, Humana provided a high level of financial support to the state of Florida, taking responsibility for many jobs and a large share of wages and taxes. Recent news from Humana...

AHIP Reveals Org to Support Stakeholders during Medicaid Redetermination

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AHIP has introduced a new outlet for healthcare industry collaboration around the Medicaid redetermination process: the Connecting to Coverage Coalition (CCC). The payer organization and its partners...

Health Insurance Impacts Racial Inequities in Cervical Cancer Diagnoses

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Health insurance coverage may help mitigate racial inequities in advanced-stage cervical cancer diagnoses, according to a study published in JAMA Network Open. Undergoing regular cervical cancer...

CareOregon Initiative Boosts Access to Housing for Community Members

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CareOregon has purchased a Red Lion Inn & Suites to help increase access to housing for the healthcare workforce and underserved communities. The payer plans to convert the space in Seaside,...

How Medicaid Managed Care Orgs Can Better Invest in SDOH Interventions

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Medicaid managed care organizations can leverage financial bonds to help increase funds for social determinants of health interventions and avoid underinvesting, according to research published in...

Women Face High Out-of-Pocket Costs for Breast Cancer Treatment

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The annual out-of-pocket cost for women with an invasive breast cancer diagnosis receiving insurance coverage through an employer-sponsored plan was $1,502.23, a study published in JAMA Network Open...

CareFirst, Aledade Partnership to Help PCPs with Value-Based Care

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CareFirst BlueCross BlueShield (CareFirst) has formed a strategic alliance with Aledade, Inc. (Aledade), offering independent primary care physicians tools and resources to improve healthcare...

BMA Asks CMS to Rethink Medicare Advantage Risk Adjustment Model Changes

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Better Medicare Alliance (BMA) has urged the Centers for Medicare and Medicaid Services (CMS) not to finalize its proposed changes to the Medicare Advantage risk adjustment model, stating that they...

UnitedHealthcare Provides Funding to Support Workforce Development

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The UnitedHealthcare Community Plan of Georgia will provide Step Up Savannah with a $95,000 grant in support of its efforts to provide underserved communities with training, healthcare screenings, and...

Humana Collab Expands Value-Based Care for Medicare Advantage Members

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Humana has partnered with an independent primary care network to enhance access to value-based care for Medicare Advantage members. The 10-year collaboration with Aledade will allow Humana’s...

States with Highest COVID Medicaid Enrollment May See Big Losses Post-PHE

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With Medicaid continuous enrollment coming to an end on March 31, 2023, states are expected to see a decline in Medicaid enrollment after three years of growth, a Kaiser Family Foundation (KFF)...

Blue Shield of CA Expands Access to Mental Healthcare Resources

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Blue Shield of California has expanded access to mental healthcare resources by connecting members to an online platform that offers personalized well-being assessments and information. The platform,...

BCBSM Funds Community-Based Orgs to Improve Senior Wellbeing

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Blue Cross Blue Shield of Michigan has provided grant funding to community-based organizations in Washtenaw County to help support the health and wellbeing of older adults. The payer is one of three...

NCQA Recognizes WI UnitedHealthcare Plan for Health Equity Efforts

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UnitedHealthcare Community Plan of Wisconsin has been recognized by the National Committee for Quality Assurance (NCQA) for its efforts to advance health equity and address care disparities. The NCQA...

Top Threats, Priorities in Employer-Sponsored Health Plan Benefits

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Employers shared the main threats and priorities that they encounter as they try to manage employer-sponsored health plan benefits, according to a survey from the Midwest Business Group on Health...