Healthcare Spending

Average ACA Exchange Premiums Drop for Third Year Running

by Kelsey Waddill

The downward trend in ACA exchange premiums continued this year with the average premium for the benchmark plan dropping two percent for 2021 coverage year, although some premiums remain up to 36...

Payer Premiums, Out-of-Pocket Costs Burden Medicare Beneficiaries

by Kelsey Waddill

Medicare beneficiaries are concerned about their future healthcare costs, particularly related to their health insurance, a MedicareGuide.com survey revealed. The results represent the online...

Payer Strategies For Home Healthcare, Remote Patient Monitoring

by Kelsey Waddill

Home healthcare and remote monitoring are increasingly critical to providing value-based care, improving quality while keeping costs low. Experts have discovered that, in some cases, remote patient...

COVID-19 Has Negative Impact on Stalling ACA Marketplaces

by Kelsey Waddill

Healthcare improvements through the Affordable Care Act marketplaces had stalled before the coronavirus pandemic struck the US and COVID-19 has only further exposed the system’s weaknesses, the...

How States, Employers Control ESI Healthcare Spending Long-Term

by Kelsey Waddill

States, employers, and the federal government must each play a role in supporting sustainable employer-sponsored insurance spending solutions during the coronavirus pandemic, a recent United States of...

New Aetna Health Plan Leverages CVS HealthHUBs, Narrow Networks

by Kelsey Waddill

Aetna is initiating a new employer-sponsored health plan in Kansas and Missouri that will combine a narrow network with CVS Health services, the payer announced. “This plan is just one example...

How Payers Can Calm Member Fears, Push Virtual Care Adoption

by Kelsey Waddill

As the healthcare landscape is becoming more digitized, payers can take steps to prevent members from falling back into old, non-digital forms of care, a recent Accenture report highlighted. The...

Aetna Fined $500,000 for Denying Emergency Room Claims in CA

by Kelsey Waddill

Aetna has been fined by California’s Department of Managed Health Care for denying emergency room claims against the state’s standards. “The plan’s failure to follow California...

ACA Special Enrollment Members Have Higher Healthcare Spending

by Kelsey Waddill

Affordable Care Act marketplace beneficiaries who enroll in plans during special enrollment periods tend to exhibit higher healthcare spending, a recent Health Affairs article revealed. The...

Aetna, Cleveland Clinic Form Low Cost, Narrow Network Health Plan

by Kelsey Waddill

CVS Health’s Aetna has formed a new partnership with Cleveland Clinic which involves a new narrow network health plan and new provider programs, the payer and provider announced. “As part...

Rewards, Cash-Back Programs Incentivize Lower Healthcare Spending

by Kelsey Waddill

Payers can reduce unnecessary healthcare spending by incentivizing consumers to choose lower cost healthcare providers, a study from the Pioneer Institute focusing on Massachusetts-based payers...

Empowering Member Decision-Making in Chronic Disease Prevention

by Kelsey Waddill

Blue Shield of California’s latest partnership focuses on empowering member decision-making for better chronic disease prevention and management, specifically for chronic kidney...

AHIP Responds to Lawmaker Questions on Payer COVID-19 Profits

by Kelsey Waddill

As major payers release their second quarter earnings reports, policymakers are growing wary of the skyrocketing revenue, culminating in the House Committee on Energy and Commerce’s investigation...

Key Payer Strategies to Improve Colorectal Cancer Preventive Care

by Kelsey Waddill

Risk factors for colorectal cancer are growing more prevalent even in younger age groups, meaning payers need to improve colorectal cancer preventive care, a Blue Cross Blue Shield Association (BCBSA)...

CMS Reveals Low Part D Premium, AHIP Warns of Rebate Rule Impact

by Kelsey Waddill

The average basic premium for Medicare Part D prescription plans will be the second lowest average Part D premium since 2013, CMS announced. “The Trump Administration has prioritized policies...

Commercial High Deductible Plans May Not Impact Member Outcomes

by Kelsey Waddill

Contrary to expectations, there may not be a correlation between deductible costs and member outcomes for commercial high deductible plans, according to a study published in JAMA Open Network. The...

CMS Transferred $10.8B in Risk Adjustment Payments, Charges in 2019

by Kelsey Waddill

The blow to employer-sponsored plans in the final three quarters of 2020 could be lower than anticipated largely because coronavirus impacts have concentrated on lower income populations, Robert Wood...

Payers See Low Employer Satisfaction, Provide Limited Support

by Kelsey Waddill

Employers are largely underwhelmed by payer efforts in a variety of areas including value-based care payment reform, resulting in low employer satisfaction rates, according to a survey from The...

How Employers, Payers Can Partner through the Workplace Transition

by Kelsey Waddill

More than six in ten employers said that they would be partnering with their healthcare payer in the workplace transition back to the office, an Optum survey found. The survey revealed that only 16...

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