An Anti-Kickback and False Claims Act lawsuit against Humana and Roche Diagnostics Corp. and Roche Diabetes Care, Inc. (Roche) has finally come to a close, Sanford Heisler Sharp, LLP announced.
The...
In the year before the pandemic, the US spent a whopping $3.6 trillion on healthcare, with payer spending comprising a third, or $1,195 billion, of that, according to a report from the Congressional...
Payers are not leveraging care management to its fullest capacity and they have an opportunity reform their care management programs to improve quality of care and return on investment, a report from...
Medicare coverage increases seniors’ access to care and reduces affordability barriers, a study published in Health Affairs discovered.
“The Medicare program pays for roughly one of every...
The recent executive order from the Biden administration represented a reversal in US healthcare policy that could have major implications for Medicaid and the Affordable Care Act...
If the remaining 14 states that have not expanded their Medicaid programs had decided to pursue Medicaid expansion in 2020, their decision could have helped reduce uninsurance during the pandemic, an...
Overall, UnitedHealthcare saw members’ care activity return to normal levels in the fourth quarter of 2020, payer executives announced during UnitedHealth Group’s 2020 fourth quarter...
The Biden Administration’s coronavirus relief plan seeks to expand healthcare coverage during the pandemic by increasing and extending COBRA and Affordable Care Act premium subsidies and...
In an effort to encourage virtual care and primary care services utilization, UnitedHealthcare is expanding its virtual care policies so that more members can have access to virtual care visits as an...
Payers have started announcing partnerships and investments for 2021 that aim to address social determinants of health, particularly food scarcity, housing insecurity, and health equity.
Some experts...
Centene has signed an agreement to acquire Magellan Health in order to better integrate its behavioral healthcare and physical healthcare services, the major payer announced.
“There is a...
About four and a half years ago, Chris Carlson, senior vice president of customer experience and complex health solutions at UnitedHealth Group, had a significant conversation with his colleague about...
Payers may consider promoting ambulatory surgery centers as the ideal site of care for joint replacement surgeries, UnitedHealth Group’s recent research findings suggested.
“Findings from...
Overall healthcare spending in the US rose 4.6 percent in 2019 to hit $3.8 trillion, with private payers contributing a little more than three out of every ten healthcare dollars (31 percent), a recent...
Medicare Advantage quality of care exceeded traditional Medicare, particularly in preventive care, a recent Better Medicare Alliance study revealed.
“The hallmark features of Medicare...
Ambetter, a health insurance product from Centene Corporation, has reduced out-of-pocket healthcare spending by collectively giving members millions of dollars in rewards through their My Health...
Copayments and coinsurance can impact care utilization in employer-sponsored health plans depending on the service, a recent study published by Employee Benefit Research Institute (EBRI)...
Employers are gravitating toward integrated health care benefits to improve member engagement and patient experience as well as lower healthcare spending, according to a report commissioned by...
The coronavirus pandemic has highlighted many of the problems in the healthcare system including the practice of price gouging, according to a recent America’s Health Insurance Plans (AHIP)...
In the San Francisco Bay Area, employers face the challenge of escalating healthcare spending.
This problem is not restricted to the Bay Area alone. Average premiums nationwide were around $7,470 for...
