Medicare Advantage special needs plans (SNPs) may help control healthcare spending for patients with end-stage renal disease (ESRD), a recent study published by Health Affairs found.
CMS established a...
Smoking can lead to higher premiums, a recent study on the tobacco surcharge and tobacco users’ Affordable Care Act marketplace premiums revealed.
According to the Centers for Disease Control...
For the past couple of years, employers have increasingly used centers or excellence (COE) to bolster the quality of healthcare benefits, but health plans can leverage these centers as well to improve...
Blue Shield of California has partnered with a third-party vendor to make social determinants of health data accessible to anyone.
Payers and providers talk extensively about sharing social...
The coronavirus pandemic may be having an effect on Americans’ exercise life, a recent UnitedHealthcare survey discovered, which may in turn impact payer wellness programming to meet employee...
Blue Shield of California’s latest partnership focuses on empowering member decision-making for better chronic disease prevention and management, specifically for chronic kidney...
Humana will be partnering with a chronic kidney disease management and awareness organization to provide home healthcare and care coordination to Medicare Advantage members, the payer recently...
Updated 7/22/20: This article has been updated to reflect that Wellvolution is a Blue Shield of California program. A previous version said Blue Shield of California partnered with...
Payers expend billions every year on type 2 diabetes in the US, but the programs that are intended to help members manage chronic disease are not working, charged Amy Meister, DO, chief executive...
Payer social determinants of health strategies are moving into a new phase, as Humana’s latest Bold Goal report demonstrated.
Over the past few years, payers have gained deeper knowledge about...
Value-based insurance designs that incorporate zero copay programs for certain drugs may help decrease total chronic disease spending—including member and payer costs—when the designs focus...
The number of commercially insured Americans age 30 to 64 diagnosed with early-onset dementia or Alzheimer’s disease increased by 200 percent from 2013 to 2017, according to an assessment of...
Update 03/03/2020: This article has been updated to reflect that Oscar Health might expand the number of options for migraine prescriptions. A previous version implied that there were no migraine...
Blue Cross Blue Shield of Massachusetts (Blue Cross) is expanding its value-based care model into its dental plan through value-based contracting with the dental provider group 42 North.
In 2019,...
While payers and Medicare Advantage proponents applauded elements of the Medicare Advantage rule that CMS proposed yesterday which will increase plans’ revenues by nearly one percent, many...
The drug pricing and coverage plan at Veterans Health Administration (VHA) is poised to improve medication adherence, with the payer boasting a 5.9 percentage point lower rate of cost-related...
A judge blocked a California bill, AB 290, that would prevent dialysis providers from encouraging end-stage renal disease (ESRD) patients to select health plans that some say offer dialysis providers...
Humana announced that it is pursuing a vertical consolidation deal with Enclara Healthcare, one of the largest hospice pharmacy and benefit management providers (PBMs) in the country.
Humana will...
Payers are using coordinated care and precision medicine to make diagnoses more quickly and ensure a strong treatment plan for severe and chronic disease management.
Early detection of chronic and...
Five gaps prevent Medicare Advantage health plans from engaging in successful patient-centered care for chronic disease management, a HealthMine survey concluded.
"We see that plans have definitely...
