Over half of the public rate filings from payers on the individual and small group health insurance market are proposing 2021 premium rates changes between a two percent decrease and a six percent...
Dual eligibles with end-stage renal disease (ESRD) differ from non-duals in demographic factors as well as healthcare spending characteristics, but their healthcare utilization rates are the same as...
The number of Medicare Advantage plans is increasing, while typically being of higher quality and yielding more cost-savings as opposed to fee-for-service Medicare, Better Medicare Alliance argued in...
Seriously ill populations tend to enroll in health plans that are less restrictive and that boast broader networks, a recent American Journal of Accountable Care (AJAC) study found.
The AJAC study...
The Centers for Disease Control and Prevention (CDC) estimates that 90 percent of national healthcare spending goes toward chronic disease management and mental healthcare, which means that strong...
Medicare Advantage plans may see higher healthcare spending on end-stage renal disease (ESRD) populations when the new Medicare Advantage and Part D rule goes into effect, an Avalere study...
Mental healthcare utilization and specialty drug spending will increase healthcare spending in 2021, but this will be counterbalanced to some degree by widespread telehealth adoption and narrower...
Value-based insurance designs that incorporate zero copay programs for certain drugs may help decrease total chronic disease spending—including member and payer costs—when the designs focus...
Experts slightly lowered their estimate for payer COVID-19 healthcare spending to a high of $546.6 billion based in part on adding delayed care savings, a study by Wakely Contracting Group found....
While overall out-of-network or potential surprise billing is slightly declining, out-of-network healthcare spending is on the rise for laboratory tests and hospitalists—particularly in...
Although insulin prices more than doubled between 2006 and 2017, out-of-pocket insulin costs for commercial plan members remained fairly steady over the course of that period, even declining slightly...
As payers setting rates for 2021 seek greater clarity on coronavirus costs, experts warned in a recent Health Affairs article that the direct medical COVID-19 healthcare spending could range from...
Extending postpartum Medicaid insurance could make postpartum healthcare more affordable for new mothers and improve health outcomes , a recent report from the Urban Institute found.
“Uninsured...
Coronavirus is changing member and beneficiary healthcare spending habits, including increased telehealth utilization and but lower overall healthcare utilization, a recent PwC Health Research...
Surplus funds that would normally go toward nonessential health services will instead be used to extend premium credits and waive cost-sharing for hard-hit populations, Priority Health announced.
For...
The individual health insurance market will experience the economic impact of coronavirus in three major ways, including potentially lower COVID-19 treatment costs, a Robert Wood Johnson Foundation...
Private payers pay nearly double the amount that Medicare pays for certain services and a hospital’s market share play a significant role in the positive margin, a recent literature review...
The hole that coronavirus leaves in private payer, Medicare, and Medicaid healthcare spending is largely reliant on the length of the outbreak and how much a dip in elective procedures offsets...
The Food and Drug Administration (FDA) and Federal Trade Commission (FTC) can streamline the biosimilar approval process and adopt other strategies to promote biosimilars and lower healthcare spending,...
Member engagement strategies need to make better use of advanced analytics, be more attuned to members’ journeys of care, and culminate in a tight, dedicated team with a broad range of...
