Access to Care

92% of Counties Have Affordable Care Act Plans with 3 to 5 Stars

by Kelsey Waddill

Over nine in ten counties boasted a medium- or high-quality health plan as their highest-rated plan on the Affordable Care Act marketplace in 2020, according to a Health Affairs article. Researchers...

National Coverage Determination May Limit Access to AD Treatment

by Kelsey Waddill

CMS has released a national coverage determination draft for the Alzheimer’s drug, Aduhelm or aducanumab, but coverage limitations in the draft may create access to care challenges for seniors...

BCBSA Partnership Aims to Increase Access to Low-Cost Insulin

by Victoria Bailey

The Blue Cross Blue Shield Association (BCBSA) has partnered with a nonprofit generic drug company to help increase access to low-cost insulin for members living with diabetes. Along with several...

Humana Transitions Home Healthcare Products to CenterWell Brand

by Kelsey Waddill

Humana is transitioning its Kindred at Home home healthcare products to the CenterWell Home Health brand. The transition entails apparel and other branded material changes from Kindred at Home...

BBBA, Medicaid Expansion Could Expand Coverage For HIV Community

by Kelsey Waddill

In states that have not adopted Medicaid expansion, individuals with HIV have limited access to care, but pending legislation and potential future expansions could change those circumstances, a Kaiser...

CMS Updates Medicare Coverage for Certain Lung Cancer Screenings

by Kelsey Waddill

CMS has announced that it will expand the eligibility criteria for a national coverage determination for lung cancer screenings. “Expanding coverage broadens access for lung cancer screening to...

How OR Plans to Use a Public Option to Advance Health Equity

by Kelsey Waddill

As Oregon establishes a public option in order to address health equity, it could merge this work with its efforts to unify health equity goals across health insurance markets and the state, a Manatt...

Record-Breaking ACA Open Enrollment Gains 5.8M New Enrollees

by Kelsey Waddill

CMS and HHS have announced that the Affordable Care Act marketplace gained 5.8 million new enrollees in the 2022 open enrollment season, contributing to a record-breaking 14.5 million...

How Private Payers, Medicaid Cover At-Home COVID-19 Testing

by Kelsey Waddill

A handful of the largest private payers are evenly split regarding whether they provide direct coverage for at-home COVID-19 testing, according to the Kaiser Family Foundation (KFF) which assessed both...

The Role of Medicaid Plans in Assuring LGBTQI+ Access to Care

by Kelsey Waddill

Medicaid plans have a key role to play in improving access to care and health equity for the LGBTQI+ community, according to a report from the Association for Community Affiliated Plans...

How The Affordable Care Act Impacted Small Group Coverage Trends

by Kelsey Waddill

From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute found. The researchers used the Medical Expenditure Panel Survey Insurance...

CHIP Coverage Option May Help Improve Prenatal Care for Immigrants

by Victoria Bailey

By implementing the CHIP coverage option for immigrants and their children, policymakers can help reduce maternal and infant mortality and ensure that pregnant individuals receive adequate prenatal...

At-Home COVID-19 Tests in Low Supply Before New CMS Requirements

by Kelsey Waddill

In a sample of online retailers, only a fraction of the at-home COVID-19 testing opportunities were available the week before CMS announced the new at-home COVID-19 test coverage requirements for...

Payers Lag On Acupuncture Coverage Despite Rising Utilization

by Kelsey Waddill

Although acupuncture utilization has grown in recent years, only half of acupuncture visits had any form of coverage in 2019, according to a research letter published in JAMA Network Open. The...

HRSA Expands Preventive Care Coverage Under ACA for Women, Children

by Victoria Bailey

The Health Resources and Services Administration (HRSA) has updated the preventive healthcare guidelines under the Affordable Care Act (ACA) to expand low-cost coverage of preventive care services for...

CMS Releases 2023 Medicare Advantage, Part D Proposed Rule

by Kelsey Waddill

CMS released the calendar year 2023 Medicare Advantage and Part D proposed rule which aims to improve network adequacy, elucidate medical loss ratio reporting, open the possibility of assigning star...

UHC Will Not Implement Emergency Care Coverage Changes

by Kelsey Waddill

UnitedHealthcare has clarified that it does not intend to change its emergency care coverage policies, American Hospital Association (AHA) disclosed in a special bulletin. “AHA is pleased with...

Medicaid Asset Test Revisions May Increase Dual Eligibility for Seniors

by Victoria Bailey

Adjusting the Medicaid asset test to accurately reflect inflation levels could increase Medicaid eligibility for low-income, elderly, and disabled Medicare beneficiaries, according to a Health Affairs...

Payer Funds Tech, Training To Support Rural Maternity Healthcare

by Kelsey Waddill

Blue Cross and Blue Shield of Minnesota (Blue Cross) is funding a hospital partner’s technology and practice support resources in order to transform rural maternity...

MA Plan Introduces Benefits to Address Chronic Disease Management

by Victoria Bailey

MVP Health Care and the University of Vermont Health Network (UVMHN) have added heart disease and diabetes support to their Medicare Advantage plan benefits to improve chronic disease management for...