Humana’s value-based care models in Medicare Advantage helped lower emergency room admissions and, in turn, boosted savings for Medicare Advantage members, according to the payer’s recent...
When a major crisis hits, gathering quality measures data can be challenging or nearly impossible with the current strategies.
In order for a health plan to be accredited by the National Committee for...
Since the passing of late Supreme Court Justice Ruth Bader Ginsburg, many have questioned whether the Affordable Care Act is at risk of being overturned, a potentiality that would be extremely...
Healthcare improvements through the Affordable Care Act marketplaces had stalled before the coronavirus pandemic struck the US and COVID-19 has only further exposed the system’s weaknesses, the...
Low income and minority seniors as well as those who are almost of age to become Medicare beneficiaries require greater financial and coverage support from the Medicare program, researchers from...
Temporary Medicaid coronavirus flexibilities and funding may be about to expire and CMS needs to be clearer about transition guidelines in order to help states be prepared, Kaiser Family Foundation...
Employer-sponsored healthcare coverage dropped nearly two percent between late-April 2020 and mid-July 2020, according to a Robert Wood Johnson Foundation (RWJF) report that corroborates a couple...
Major payers are beginning to send out individual and small group rebate checks for 2019, providing some financial relief for members, as the Tennessee Department of Commerce and Insurance...
Minorities may see a sharper loss in employer-sponsored health insurance than White populations in America, which would drive racial coverage and health disparities even deeper, a recent report from...
Concerns over provisions of the Medicaid Fiscal Accountability Rule (MFAR) have compelled CMS to rescind the rule proposed last November.
In a tweet late Monday, CMS Administrator Seema Verma...
States, employers, and the federal government must each play a role in supporting sustainable employer-sponsored insurance spending solutions during the coronavirus pandemic, a recent United States of...
As the coronavirus pandemic continues to rage across the US, the payer industry must consider how the current environment will affect Medicare Advantage Star Ratings for years to come. The industry may...
Most states have had to expand their Medicaid long-term supports and services coverage and benefits in order to protect some of the most vulnerable populations from the coronavirus, which could have...
As the healthcare landscape is becoming more digitized, payers can take steps to prevent members from falling back into old, non-digital forms of care, a recent Accenture report highlighted.
The...
Coronavirus-related employer-sponsored insurance losses could be loser than initially expected, although it’s still unclear due to a lack of definitive data, according to a report from the Robert...
As fall approaches and the coronavirus continues to affect daily life, parents must decide whether and how to send their children back to school and payers must consider population health strategies...
Aetna has been fined by California’s Department of Managed Health Care for denying emergency room claims against the state’s standards.
“The plan’s failure to follow California...
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...
If the federal government wants to prevent more healthcare workers from becoming unemployed, it needs to do more to bolster employer-sponsored insurance, pushed a report from FamiliesUSA.
Because...
Although not as active as prior years due to the coronavirus pandemic, the landscape of payer dealmaking continues to show signs of life through innovative consolidations and partnerships.
Payers...
