What Are Major Payers Offering Medicare Advantage Members in 2024?
As Medicare’s open enrollment period approaches, payers have announced new Medicare Advantage plan offerings for 2024. Because Medicare Advantage plans receive flexibility to cover...Total Adoption of Continuous Eligibility May Improve Coverage Rates
While Congress has taken steps to ensure continuous eligibility for children on Medicaid, data indicates that expanding continuous eligibility to adults could result in lower uninsurance, some cost...CMS: Medicare Advantage Premiums Will See Little Change in 2024
Ahead of the Medicare Open Enrollment Period, CMS has announced that Medicare Advantage premiums, benefits, and plan choices will remain relatively stable in 2024. “A top priority for CMS...Employers Expect Highest Health Plan Benefits Cost Growth in 10 Years
In 2024, experts anticipate that health benefits costs will increase 5.4 percent on average per employee, according to Mercer’s National Survey of Employer-Sponsored Health Plans 2023. Mercer...Hospital Outpatient Department Costs Consistently Outpace Offices, ASCs
Given the significant difference between cost of care in hospital outpatient department settings compared to other settings for the same services, site-neutral payments could reduce healthcare...Sponsored Article
Improving Payment Integrity with a Building Blocks Methodology
Healthcare costs are increasing, and health insurers can expect — by some estimates — to spend 7 percent more in 2024. In this environment, payment integrity teams have a strategic...Trends in Price Ratios Between Commercial, Medicare Advantage Plans
Insurers often negotiate hospital prices for their commercial health plans that are up to five times the Medicare Advantage price, a study published in Health Affairs found. It was already a...ACA Marketplace Premiums Set to Rise Again, Inflation a Key Factor
Even as inflation seems to be plunging from its peak, the ongoing pressure from high medical costs is set to push ACA Marketplace premiums up to an average of 6 percent in 2024, according to...Consumers Blame Payers, Utilization Management for Delays in Care
Consumers do not agree that insurers are protecting them from high out-of-pocket costs and find that utilization management practices—such as prior authorization and formulary...Unnecessary Utilization in CO Leads to $134M in Healthcare Spending
Updated 8/24/2023: This article has been updated to reflect that the share of healthcare spending on low value care was highest in commercial health plans. Previously, the article framed...Sponsored Article
