As employers strive to help members lower costs, they can leverage episode-based benefit plans to guide their employees toward value-based care decision-making, according to a report from Manatt...
Some Medicare Advantage plans may have improperly used chart reviews and health risk assessments to maximize risk-adjusted payments from CMS, a report from the Office of Inspector General...
The University of Pittsburgh Medical Center (UPMC) Health Plan partnered with a meal delivery service to improve patient outcomes, decrease healthcare costs, and reduce emergency department visits for...
Healthcare B2B payment transactions have been high in 2021, potentially signaling the importance of electronic payment transfers as the nation emerges from the coronavirus pandemic, according to a...
Ambulatory surgery centers can be high value care sites for hospital outpatient services, according to UnitedHealth Group’s recent claims analysis.
Ambulatory surgery centers are care sites that...
The Alliance of Community Health Plans (ACHP) is urging the federal government to take action and lower prescription drug prices with a set of recommended actions.
The costs of prescription drugs...
The majority of the healthcare industry has taken to digitizing payments over the past few years. Still, ample opportunities remain for providers and plans to significantly reduce costs and realize...
Highmark Blue Cross Blue Shield of Delaware is raising its 2022 Affordable Care Act premium, the state’s health insurance commissioner announced.
“Stability in the individual health...
Unvaccinated COVID-19 hospitalizations cost payers and the healthcare system at large billions in healthcare spending, according to a Peterson-Kaiser Family Foundation (KFF) Health System Tracker...
Now that vaccines are readily available to all American adults, private payers have stopped waiving cost-sharing for COVID-19 hospitalizations, according to a Peterson-Kaiser Family Foundation (KFF)...
State policymakers have a few tools at their disposal as they try to lower state healthcare spending, according to a Commonwealth Fund report.
First, states can support greater competition between...
Escalations in Medicare Advantage healthcare spending—along with higher traditional Medicare spending—could drive scarcity in the Medicare hospital insurance trust fund and could boost...
Hospital admission rates and 2021 healthcare spending overall were below expected levels through early April 2021 and researchers projected that these trends could continue through June 2021, according...
CMS announced that Colorado’s state innovation waiver which introduced a state-based reinsurance program has successfully lowered average premiums and, as a result, received approval for a...
Regence BlueShield (Regence) is welcoming new providers to its value-based care program and offering coverage for additional services to lower costs and improve patient health outcomes.
The payer...
By increasing the coverage rate, Medicaid expansion may protect patients from surgical catastrophic spending, an article published in Health Affairs found.
The researchers used data from the...
Healthcare costs have declined for consumers during the special enrollment period, largely due to the American Rescue Plan Act (ARPA) subsidies, according to new data from CMS.
The Biden...
Based on 75 individual marketplace rate filings, the coronavirus pandemic is not expected to meaningfully affect healthcare spending in 2022, a Peterson-Kaiser Family Foundation (KFF) Health System...
Employer-sponsored health plans spend over $5 on healthcare benefits for every $1 lost in tax revenue due to tax exemptions, which demonstrates the advantages of employer-sponsored health plans for...
Price gouging of coronavirus tests continues to drive healthcare spending higher as out-of-network providers charge up to three times the actual cost of the test, according to recent data from...
