CMS has issued an interim final rule that raises Medicare payments for durable medical equipment (DME) to ensure Medicare beneficiaries have access to critical medical devices.
The rule will raise DME...
High quality health plan customer service is critical for payers who want to create meaningful, positive beneficiary interactions.
Customer service plays several important roles for health plans....
Payers are constantly challenged to provide their health plan beneficiaries the best possible healthcare experiences, but may have trouble doing that if members experience food insecurity.
Food...
Harvard Pilgrim and Partners HealthCare are engaging in discussion of a possible merger. A deal would combine Massachusetts’s largest payer organization with the state’s largest...
Employers may have a prime opportunity to add value to their health plan options by offering supplemental insurance, according to a recent AHIP survey.
The survey found that 95 percent of employees...
Value-based care networks are a promising opportunity for payers that want to manage costs and improve outcomes of beneficiaries. But effectively scaling collaborative, risk-based reimbursement...
The uninsured rate of working adults ages 19 to 64 rose by more than 3 percent between 2016 and 2018, according to the Commonwealth Fund’s ACA Tracking Survey.
In 2016, 12.2 percent of working...
CMS has proposed to implement value-based payment reforms for skilled nursing facilities (SNFs) and other Medicare inpatient facilities in order to reduce fraud and create higher quality healthcare...
CMS has received over 1,000 comments from healthcare payers and expert organizations that suggest the agency’s efforts to implement value-based care reform will require changes to provider...
The social determinants of health (SDOH) have gained traction in payer discussions and are driving payers to take a thoughtful look into factors that create long-lasting effects on healthcare costs and...
Senator Jeff Merkley (D-OR), with sponsorship from 11 other Democrats, has introduced a bill to create a Medicare health plan for all ages that would be offered in state and federal health exchanges,...
Humana has launched a bundled payment model to improve outcomes and lower costs of maternity by partnering with OBG-YNs across the country.
Humana’s Maternity Episode-Based Model bundles...
AHIP is urging HHS secretary Alex Azar to address adverse selection related to Medicaid or Medicare end stage renal disease (ESRD) in order to ensure that vulnerable beneficiaries continue to receive...
The American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) have announced plans to promote an alternative payment model to address opioid use disorder.
Leaders at...
Payers striving to compete in the Medicare Advantage (MA) market can add more value to their health plans by taking advantage of regulatory changes established under a new final rule.
Starting in plan...
High-deductible health plan (HDHP) and health savings account (HSA) enrollment reached 21 million members in 2017, according to new research from AHIP. These health plan options are expected to...
Humana has expanded a bundled payment model into seven additional states that will cover hip and knee replacements within Medicare Advantage populations.
The payer has teamed up with orthopedic...
CVS Health has launched new cost-saving initiatives that aim to lower beneficiary prescription drug costs through co-pay adjustments, pricing transparency technology, and increased promotion of generic...
Commercial payers leverage community financing and engagement techniques to limit patient safety risks related to the nation’s opioid crisis. Payers find that contributing information to datasets...
Payers have developed several initiatives to incorporate preventive care and wellness as part of their larger holistic health solutions.
Adding wellness and preventive care can help payers keep their...
