Nearly 11.8 million beneficiaries have enrolled or re-enrolled in a health plan through the Affordable Care Act exchanges, reaching close to 2017 enrollment totals (12.2 million) despite federal...
The Minnesota of Council of Health Plans (MCHP) associated rising beneficiary medical costs in 2017 to irregular health plan enrollment shifts in both the private and public market.
The Council said...
The BlueCross BlueShield Association (BCBSA) has announced a new professional standard that removes opioid prescriptions as a primary pain treatment in a majority of clinical situations.
The...
Walmart may be making a move to acquire Humana, one of the nation’s biggest health payers, according to The Wall Street Journal.
Citing sources familiar with the matter – but without...
The American Antitrust Institute (AAI) has warned the Department of Justice (DoJ) that the proposed CVS and Aetna merger would violate consumer protections and damage competition in the healthcare...
A group of commercial payers and other healthcare organizations have formed a coalition to explore how addressing the social determinants of health can lower care costs and improve outcomes.
A number...
Humana is improving the overall physical and mental health of its Medicare members by addressing social determinants of health and targeting problematic community health behaviors under its Bold Goal...
Significant changes to the employer-sponsored insurance market, such as increasing medical costs, policy changes, and improvements in other payer markets may cause employers to stop providing health...
Healthcare payers saw urgent care center utilization grow by 1725 percent from 2007 to 2016, indicating that urgent care may the one of the fastest-growing choices for receiving healthcare.
A white...
BlueCross BlueShield of Michigan has launched a pilot program that will use bundled payments for knee and hip replacements in order to manage costs and improve member outcomes.
BCBS data estimates...
Payers and employers who offer high-deductible health plans (HDHPs) to attract low-cost members may need member engagement strategies to generate higher value for these beneficiaries.
Member...
Commercial payers including Aetna, Cigna, and Tufts Health are launching new value-based care agreements with providers to reduce healthcare costs and increase care quality for beneficiaries.
Many...
Prior authorization issues are associated with 92 percent of care delays and may contribute to patient safety concerns as well as administrative inefficiencies, according to a new survey from...
Medicare Advantage (MA) plans contained beneficiary costs and remained profitable despite reductions to federal MA payments from 2009 to 2014, according to new research from the Commonwealth Fund.
The...
Health plan performance, and how to improve it, is always an issue at the forefront of payers’ minds. While payers have engaged in several strategies in the past aimed at improving clinical...
The BlueCross BlueShield Association has created a new subsidiary called the BlueCross BlueShield Institute to help identify and address the social determinants of health (SDOH) for its...
Payer input is critical for developing high performance networks (HPNs) that are efficient and cost-effective while delivering high quality care, says the Academy of Actuaries in a new report....
Cigna is entering the voice control product space with an Amazon Alexa feature called “Answers by Cigna” that educates beneficiaries about complex health insurance terminology and...
Value-based care helped close 50 million gaps in care between 2013 and 2017 while reducing care costs, lowering ED utilization, and increasing provider care quality, according to a new report from...
Update 8/24/2018: Cigna shareholders have overwhelmingly voted to approve the acquisition of Express Scripts. Approximately 90 percent of shareholders voted in favor of the deal, which is...
