Medicare Advantage Plan Quality Varies by Premium Cost
Premium costs may not always be representative of Medicare Advantage plan quality, as high-quality plans were found at every premium level, a study published in JAMA Health Forum found. Healthcare...Sponsored Article
How Plans Simplify Payment Integrity by Choosing the Right Partner
Effective payment integrity ensures that provider claims are processed efficiently and paid accurately. What’s more, a streamlined payment process reduces friction between payers and providers,...Employer Sponsored Health Plans Will Prioritize Mental Health in 2023
Large employers plan to expand mental health and virtual care offerings in their 2023 employer-sponsored health plans, but concerns about healthcare costs and health equity persist, according to a...UHC Rebrands Self-Funded Health Plan, Focus on Price Transparency
UnitedHealthcare has announced that it has rebranded its self-funded health plan option, which will now be called Surest but which will maintain its focus on price transparency and...Top Factors Influencing Employer Sponsored Health Plan Premiums in 2023
Employers face a challenging set of circumstances as they try to establish employer-sponsored health plan premiums for 2023. The second half of 2022 has introduced many variables that can affect healthcare prices. On the individual...How Family Income Impacts Out-of-Pocket, Catastrophic Spending on Insulin
Family income is a significant factor in the levels of out-of-pocket and catastrophic spending on insulin among insulin users, a study published in Health Affairs found. The researchers leveraged 2017...Key Factors in 2023 Individual Health Insurance Market Premiums
As payers finalize premiums for 2023 for the individual market, 2023 individual health insurance market premiums will be subject to a variety of factors, according to an issue brief from AHIP. The...Sponsored Article
Why Payers Need to Modernize the Claims Payment Experience
Insurers are much closer to their vision of claims processing in 2030 than just a couple of years ago, according to McKinsey & Company. For commercial health payers, this means an integrated,...ACA Marketplace Premiums Projected to Increase by 10% in 2023
Affordable Care Act (ACA) marketplace premiums will increase by five to ten percent in 2023, with payers attributing premium growth to rising healthcare prices and utilization rates, according to...Medicare Advantage Plans Increase Profits by Dodging MLR Limitations
Parent companies that offer Medicare Advantage plans may generate substantial profits through operating related businesses that are not subject to medical loss ratio limitations, according to a report...Workers in Injury-Prone Industries Lack Employer-Sponsored Health Plans
Employer-sponsored health plan coverage is not common among employees who face a higher risk of workplace injury, a Value Penguin study revealed. The study relied on data from the US Census...Employer Sponsored Health Plans Generate Significant ROI, Benefits
Employer-sponsored health plans will generate a 47 percent return on investment (ROI) for employers in 2022, mainly driven by reduced direct medical costs, higher productivity, and tax benefits,...ARPA Subsidy Expiration Could Drive 2023 Premium Rate Changes
The expiration of the American Rescue Plan Act (ARPA) premium subsidies and the return of Medicaid redeterminations will likely result in 2023 premium rate changes for individual and small group health...Health Insurance Is The Third-Highest Living Expense For Americans
Health insurance premiums absorb a high share of the average American’s annual income and must compete with other essential expenses to be a priority in consumers’ minds, a study from...Health Savings Accounts Do Not Control Enrollee Healthcare Spending
Health savings accounts were designed to create a more healthcare cost-conscious populace, but research indicates that these plans may fail to support that goal, according to an analysis published in...Sponsored Article
A New Mindset: How Payers Ensure a Successful Digital Transformation
The pandemic has left a lasting mark on the healthcare industry, accelerating digital transformation and forcing organizations to rethink their roles in helping consumers access and benefit from...How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries
By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase...Sponsored Article
