HealthPayerIntelligence News

AMA Defends Affordable Care Act’s Preventive Care Coverage Requirement

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The American Medical Association (AMA) defended the Affordable Care Act’s preventive care coverage requirement in an amicus brief in the case of Braidwood Management Inc, et al v Becerra. The...

Proposed Rule May Prevent Coverage Losses for Dual Eligible Beneficiaries

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The CMS proposed rule to streamline the Medicaid eligibility process could potentially prevent coverage losses for around a third of dual eligible beneficiaries, according to data from the Kaiser...

Health Insurance Price Growth Rises to 20%, Outpacing Other Medical Care

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Health insurance prices rose faster than other medical care categories’ prices but broke from normal patterns by failing to outpace the overall price increases on all goods and services, a brief...

GA Payer Helps Providers Improve Access to Care for Disabled Individuals

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Peach State Health Plan has partnered with the National Council on Independent Living (NCIL) to help improve access to care for patients with disabilities. Although healthcare facilities are designed...

Gold Carding Has Mixed Effects on Streamlining Prior Authorization Processes

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While more plans have turned to gold carding as a method for streamlining prior authorization for medical services in the past three years, the approach has a mixed success rate, according to an AHIP...

NCQA Confers Health Equity Accreditation on Elevance Health Medicaid Plans

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Elevance Health announced that 21 Medicaid plans have achieved health equity accreditation from the National Committee for Quality Assurance (NCQA). “Advancing health equity is a priority for...

Health Insurance Coverage Disruptions Tied to Higher Mortality Risks

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Health insurance coverage disruptions were associated with higher mortality risks for people with private and public insurance, a JAMA Health Forum study found. Health insurance coverage is typically...

How Health Insurance Coverage Varies Across, Within Families

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The Affordable Care Act (ACA) increased access to Medicaid and group health insurance, but the family glitch created a barrier to non-group coverage, leading to variations in health insurance coverage...

SCAN Health Plan Expands Dual Eligible Special Needs Plan in CA

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SCAN Health Plan is expanding its California Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) into San Diego County for 2023, increasing access to the state’s only FIDE-SNP. SCAN...

35% More MA Plans Offering Home-Based Supplemental Benefits in 2023

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More Medicare Advantage plans are offering supplemental benefits in 2023, including in-home support services and home-based palliative care, according to a report commissioned by Better Medicare...

Immigrants’ Premium Contributions Exceed Payer Spending on Care

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Immigrants’ premium contributions in 2017 were $58.3 billion higher than what private insurers and public programs spent on their healthcare, suggesting that immigrants help subsidize the US...

Health Insurance Is Expensive, But Americans Intend to Keep Their Plans in 2023

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Even though many Americans are concerned about health insurance costs, most plan to remain in their current health plan for 2023, according to a survey by ValuePenguin. Qualtrics sent out the online...

Medicare Advantage Premiums Rise, Zero-Dollar Premium Plan Uptake Declines

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Medicare Advantage premiums rose to $7 per month on average for 2023 open enrollment season, an eHealth survey uncovered. For the past four years, Medicare Advantage plan premium costs have been...

Early 2023 Affordable Care Act Marketplace Enrollment Exceeds 2022 Trends

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Since enrollment season began on November 1, the number of signups on the Affordable Care Act marketplace for the 2023 plan year has significantly outpaced the enrollment levels from the same timeframe...

No Surprises Act Leads to 9M Averted Surprise Bills, 275K Arbitration Claims

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The No Surprises Act effectively averted surprise bills for 9 million Americans in the first nine months of 2022, but the federal independent dispute resolution process is overwhelmed, according to a...

62% of Adults Are Unaware of Medicaid Renewals Resuming Post-PHE

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More than half of adults who are enrolled in or have a family member enrolled in Medicaid were unaware of upcoming Medicaid renewals set to resume after the COVID-19 public health emergency (PHE) ends,...

Top 5 States with the Highest Levels of Healthcare Spending

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In the top five states with the highest healthcare costs, residents may struggle to cover children’s medical bills, face burdensome premiums, or forego care due to high out-of-pocket healthcare...

CareSource Addresses LGBTQA+ Housing Social Determinants of Health Barriers

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CareSource is providing $1 million in funds to a large nonprofit senior living organization in Ohio to create a residential community specifically designed for LGBTQA+ individuals and allies in an...

ERIC: Allow Employer Sponsored Health Plans to Electronically Deliver AEOB

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The ERISA Industry Committee (ERIC), a nonprofit that represents the largest employers who are sponsors of employer sponsored health plans, responded to the request for information on the advanced...

2022 RI Life Index Finds Social Determinants of Health Barriers in RI

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Blue Cross Blue Shield of Rhode Island (BCBSRI) released its 2022 RI Life Index for the fourth year in a row in order to assess social determinants of health barriers and the impact on residents’...