Coronavirus

OK Becomes First State to Adopt Medicaid Expansion During COVID-19

by Kelsey Waddill

Oklahoma is now the first state to turn to Medicaid expansion during the coronavirus pandemic, a state ballot determined. The vote passed by a margin of less than one percentage point, local news...

Congress Considers Expanding ACA As Feds Move to Dismantle It

by Kelsey Waddill

The House of Representatives voted to expand the Affordable Care Act only days after the White House reiterated its resolve to dismantle the Affordable Care Act altogether. The House of...

Payers Continue to Expand Value-Based Contracting Despite COVID-19

by Kelsey Waddill

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will financially support local independent primary care practices as they transition to value-based care during the coronavirus pandemic,...

Tufts Health Plan Expands Substance Abuse Care Coverage

by Kelsey Waddill

Tufts Health Plan is improving its coverage for substance abuse care for both commercial and government Tufts Health Plan members through a partnership with Recovery Centers of America...

CVS Health Gives Employers Access to COVID-19 Testing Solutions

by Kelsey Waddill

Update 6/29/2020: This article has been updated to include a statement from CVS Health on Aetna’s role in the Return Ready program.  As payers support employers navigating the...

4 Ways Payers Can Invest In Mental and Behavioral Healthcare

by Kelsey Waddill

Recent investments from WellCare of New Jersey, a Centene subsidiary, demonstrate four ways that payers can dedicate resources toward mental and behavioral healthcare, including investing in provider...

COVID-19 Spotlights 3 Payer Telehealth Expansion Challenges

by Kelsey Waddill

Due to the coronavirus, telehealth utilization is soaring. Some payers have seen their telehealth utilization increase by 50 times their typical levels within a couple of months. Payers and providers...

High Deductible Health Plans Create Cost-Related Barriers to Care

by Kelsey Waddill

High deductible health plans pose a barrier to care by increasing costs for patients and causing scheduling and financial turbulence for providers, according to a survey of providers conducted by the...

Payers Support Dental Partners With Stipends, Boost Teledental Care

by Kelsey Waddill

Payers are supporting struggling dental partners directly through stipends and by covering teledental healthcare options, as in Humana’s recent decision to offer dentists additional funding. In...

4 Payer Data Points That Demonstrate Behavioral, Mental Care Parity

by Kelsey Waddill

Henry Harbin, MD, psychiatrist and advisor at The Bowman Family Foundation, and his colleagues are calling on health plans to start being more transparent about provider network behavioral and mental...

Payer COVID-19 Healthcare Spending for 2020, 2021 May Hit $546.6B

by Kelsey Waddill

Experts slightly lowered their estimate for payer COVID-19 healthcare spending to a high of $546.6 billion based in part on adding delayed care savings, a study by Wakely Contracting Group found....

6 Fixes to Improve Medicaid Coverage Access Amid COVID-19

by Kelsey Waddill

New York’s experience during the Great Recession could inform its approach to coronavirus Medicaid during the pandemic, a recent report from the United Hospital Fund suggested. For more...

Total Medicaid Expansion May Cut Uninsurance, Uncompensated Care

by Kelsey Waddill

If all of the nonexpansion states adopted Medicaid expansion, thus establishing total Medicaid expansion nationwide, there would be a 28 percent reduction in uninsurance, the Urban Institute found in...

Beyond COVID-19: Telehealth, Partnerships, Member Engagement

by Kelsey Waddill

While the coronavirus pandemic which gripped the nation in March 2020 is still in force, payers are beginning to look to the future as the nation emerges from crisis mode. Many uncertainties still hang in the air regarding the trajectory...

MA Risk Adjustment Should Include Audio-Only Telehealth Diagnoses

by Kelsey Waddill

Audio-only diagnoses should be factored into Medicare Advantage risk adjustment, Better Medicare Alliance (BMA) stated in a letter to CMS which HealthPayerIntelligence received by email. “We...

COVID-19 Healthcare Spending Hinges On Hospitalization Rates

by Kelsey Waddill

As payers setting rates for 2021 seek greater clarity on coronavirus costs, experts warned in a recent Health Affairs article that the direct medical COVID-19 healthcare spending could range from...

COVID-19 Impacts on Risk Pool, Costs Stir Rate Setting Uncertainty

by Kelsey Waddill

The coronavirus pandemic impacts on the individual health insurance market risk pool and healthcare costs for 2021 are infusing uncertainty into the 2021 rate setting process, America’s Health...

Cigna Care Card Lets Employers Support Members During COVID-19

by Kelsey Waddill

Cigna has launched Cigna Care Card to help employers provide extra financial support to their employees during the coronavirus pandemic, the payer announced. For more coronavirus updates, visit...

Claims May Rise in 2 to 3 Months As Patients Seek Deferred Care

by Kelsey Waddill

Almost 50 percent of American adults deferred care themselves or have a household member who deferred care due to the coronavirus, but more than two-thirds of those who deferred (32 percent of the...

Payers Assist States in Contact Tracing, Despite Consumer Distrust

by Kelsey Waddill

Medica, a non-profit health plan, has partnered with the Minnesota Department of Health to conduct contact tracing for the state. For more coronavirus updates, visit our resource page, updated...