Healthcare Payers

Top Challenges, Benefits of At-Home Coronavirus Testing Coverage

by Kelsey Waddill

In the first quarter of 2022, payers witnessed significant changes in at-home coronavirus testing coverage with mixed reactions. These changes—and the influence of the coronavirus pandemic on preventive care—present both...

Privately Insured Catheter Users Incurred High Out-of-Pocket Costs

by Victoria Bailey

Catheter users who received health insurance coverage from private health plans incurred higher annual out-of-pocket costs compared to catheter users on a government or public health plan, according to...

Commercial Health Plan Trends Reveal High Turnover, Reenrollment Rates

by Victoria Bailey

Around 20 percent of commercial health plan members disenrolled from their plans each year, but a third of those members returned to the plan within five years, suggesting that payers may benefit from...

Top 10 Most Expensive Chronic Diseases for Healthcare Payers

by Hayden Schmidt

Chronic diseases are on the rise in the United States, leaving healthcare payers with the challenge of covering care for patients with these expensive, long-term conditions. Chronic diseases are such...

Applying Whole Person Care to Digital Care for Underserved Members

by Kelsey Waddill

Payers have a significant role to play in ensuring that underserved populations receive whole person care, particularly among Medicaid beneficiaries. First, they can serve as a bridge between Medicaid beneficiaries and their primary care...

AHIP Calls On Congress to Address Price Gouging of COVID-19 Tests

by Victoria Bailey

AHIP is urging Congress to take action and address the ongoing price gouging of COVID-19 tests that payers are facing from out-of-network providers. In a statement submitted to the House Committee...

How to Hone Wellness Programs Using Social Determinants Data

by Kelsey Waddill

Are wellness programs working? This question is a common refrain for employers and their payer partners, but the answer remains ambiguous. On the one hand, some studies have supported wellness programs as a cost-effective way to...

Consumers Face Struggles with COVID-19 Testing Access, Coverage

by Victoria Bailey

More than 20 percent of consumers have experienced barriers to COVID-19 testing in the last six months, such as struggling to find a test or forgoing a test because there were no testing options...

UnitedHealthcare Offers Initiatives to Improve Vision, Eye Health

by Victoria Bailey

UnitedHealthcare has announced two new initiatives that aim to help adults and children support their vision and eye health by reducing exposure to blue light from digital screens. The COVID-19...

Top 5 Insurers With The Highest Market Shares In The Most States

by Kelsey Waddill

Payers that hold the highest market shares nationwide may not have the greatest predominance in a single state, a HealthCareInsider analysis found. UnitedHealth Group is considered the company with...

New BCBSA Plan Product Prioritizes Labor Union Health Insurance

by Victoria Bailey

CareFirst of Maryland, Inc (CareFirst) and Highmark, Inc (Highmark) have partnered to offer a new product to eligible members that prioritizes affordable, high-quality labor union health...

Electronic Payment Adoption Key to Healthcare Industry Savings

by Kyle Murphy, PhD

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...

Going Beyond Compliance: How Payers Can Embrace Healthcare Interoperability

by Kelsey Waddill

Payers may be prepared to comply with the interoperability rule for the July 1 deadline, but are they ready to adopt healthcare interoperability long-term? For the past couple of years, CMS has pushed the industry to take bigger steps...

Payer Announces Partnership to Address Opioid Misuse, Disposal

by Victoria Bailey

CareSource has announced a partnership with a medication disposal solution to help members avoid accidental poisoning and opioid misuse. The solution is a powder that disables the active ingredients...

Humana Expands Value-Based Care Model to Cover More Seniors

by Victoria Bailey

Humana’s CenterWell Senior Primary Care (CenterWell) is expanding its value-based care model to Original Medicare members to improve care quality and health outcomes, as well as lower the cost of...

Payer Partners with Nonprofit to Improve Prenatal Care Access

by Victoria Bailey

The United Health Foundation has announced a partnership with the nonprofit organization CAMBA, Inc. to improve health outcomes and increase prenatal care access for women in Brooklyn. The United...

PAHCF Opposes Medicare Expansion, Suggests Extending ACA Policies

by Victoria Bailey

The Partnership for America’s Health Care Future (PAHCF) has voiced their opposition to Medicare expansion, which would open up Medicare coverage to younger Americans in a recent statement which...

ACHP Urges Policymakers to Solidify Affordable Care Act Changes

by Victoria Bailey

The Alliance of Community Health Plans (ACHP) released recommended steps to build on the success of the Affordable Care Act (ACA) and enhance and expand coverage in the...

Blue Shield Aims to Reduce Mental Health Racial Care Disparities

by Victoria Bailey

To help combat racial care disparities in communities of color, Blue Shield of California (Blue Shield) provided $300,000 to 12 different...