Access to Care

How Do Payers Cover Prenatal, Postpartum Care for Pregnant People?

by Victoria Bailey

Prenatal, perinatal, and postpartum care help ensure healthier pregnancies and better birth outcomes for pregnant people. Access to this essential care comes easier with adequate health insurance. Pregnant people are almost guaranteed...

Blue Cross Blue Shield of MA Eliminates More Prior Authorizations

by Kelsey Waddill

Blue Cross Blue Shield of Massachusetts (“Blue Cross”) joined other payers in eradicating prior authorizations for certain services as part of an effort to accelerate members’ access...

Medicare ACO Enrollment Did Not Improve Mental Healthcare Outcomes

by Victoria Bailey

Medicare beneficiaries newly enrolled in accountable care organizations (ACOs) did not see any improvements in their depression and anxiety symptoms, suggesting Medicare ACOs may need better incentives...

Cardiovascular Disease Utilization Grew After Medicaid Expansion

by Kelsey Waddill

Adults with cardiovascular disease are more likely to utilize outpatient cardiovascular services in Medicaid expansion states than in nonexpansion states, a study published in Health Affairs...

What Non-Medical Supplemental Benefits Will MA Plans Offer in 2024?

by Victoria Bailey

Food and produce services are the most common non-medical supplemental benefit in Medicare Advantage for 2024, offered by 1,475 plans, a report from ATI Advisory found. In addition to offering typical...

Finances, Mental Health Concerns Impact Adults’ Wellbeing, Cigna Finds

by Victoria Bailey

Americans are feeling more optimistic about their wellbeing than last year, but financial concerns and mental health challenges are still negatively impacting their health, according to a report from...

3 Steps One Medicaid MCO Took to Boost Its Patient Experience Score

by Kelsey Waddill

Ease and efficiency in access to care contribute to the patient experience measurement in the National Committee on Quality Assurance’s (NCQA) Health Plan Report Card for Medicaid managed care...

Employer Sponsored Health Insurance Premiums Grew by 7% in 2023

by Victoria Bailey

The average annual premium for employer-sponsored health insurance increased by 7 percent in 2023, a KFF survey revealed. The 2023 benchmark KFF Employer Health Benefits Survey included interviews...

Alignment Health to Offer Medicare Advantage Plans That Address SDOH

by Victoria Bailey

Alignment Healthcare has partnered with Instacart to offer Medicare Advantage plans in 2024 that address social determinants of health, including food insecurity and transportation access. “Our...

AMA: Commercial Coverage of Digital Medicine Services is Inconsistent

by Victoria Bailey

Commercial coverage policies for digital medicine Current Procedural Terminology (CPT) codes are inconsistent and lag behind Medicare, an issue brief from the American Medical Association (AMA)...

Cigna Healthcare Invests $1M to Reduce Food Insecurity for Seniors

by Victoria Bailey

Cigna’s health benefits provider, Cigna Healthcare, will invest $1 million in community-based organizations to address food insecurity among older adults. “Too many people in our country,...

Anthem Blue Cross Grants CA Orgs $1.2M to Address Mental Health

by Victoria Bailey

Anthem Blue Cross Foundation has awarded $1.2 million in grants to five California-based organizations that focus on addressing mental health and substance use disorders in surrounding...

Blue Shield of CA Technology Partnership Improves Care Management

by Victoria Bailey

Blue Shield of California has partnered with a software company to improve care management services for members and streamline enrollment for employers. Through its collaboration with Salesforce, the...

Beneficiaries with Cancer Spend Less Out-of-Pocket in Medicare Advantage

by Victoria Bailey

Medicare Advantage beneficiaries with cancer experienced lower out-of-pocket costs and had access to more benefits than those in Medicare fee-for-service (FFS), research conducted by ATI Advisory and...

Cigna Removes Prior Authorization for 25% of Medical Services

by Victoria Bailey

Cigna Healthcare is removing prior authorization requirements for nearly 25 percent of medical services, facilitating access to care for members. The Cigna Group’s health benefits provider...

How Payers Are Reducing Prior Authorizations, Limiting Care Disruptions

by Victoria Bailey

Although prior authorization aims to control costs and limit unnecessary medical procedures, healthcare stakeholders have continued to raise concerns that the process creates substantial administrative...

How One MA Plan Prioritized SDOH to Improve Diabetes Care Access

by Victoria Bailey

Health plans must look beyond clinical outcomes and address social determinants of health to improve beneficiaries’ health. Zing Health, an Illinois-based Medicare Advantage plan, did just that for beneficiaries living with...

Biden Admin Proposes Mental Health Parity in Private Health Plans

by Victoria Bailey

The Biden-Harris Administration has proposed a rule to improve access to mental healthcare for privately insured Americans by establishing mental health parity requirements. The rule supports the...

Medicare Advantage Plans Have Narrow Psychiatrist Networks, Study Finds

by Victoria Bailey

Psychiatrist networks in Medicare Advantage plans are narrower than those in Medicaid managed care and Affordable Care Act (ACA) plans, according to a study published in Health Affairs. As demand for...

Medicaid Expansion Improved Palliative Care Access for Cancer Patients

by Kelsey Waddill

Medicaid beneficiaries with late-stage cancer might have greater access to palliative care in states that have adopted Medicaid expansion, a study published in Health Affairs found. The researchers...