Higher Market Share Helps Payers in Negotiations, Premium Impact Unclear
Payers with larger market shares tend to have lower prices nationally, a study published in Health Affairs confirmed. The researchers used data from Turquoise Health, a company that collects hospital...Medicare Advantage, Part D Premiums Increased Slightly in 2023
Average monthly premiums for Medicare Advantage and Part D plans have increased in 2023, and fewer beneficiaries selected zero-dollar premium plans, a report from eHealth, Inc. found. eHealth’s...AHIP Marketing Campaign Targets Pharma’s Prescription Drug Pricing
AHIP has launched a marketing campaign targeting pharmaceutical companies and the role of prescription drug pricing in healthcare spending. “Let’s be clear, Big Pharma continues to...Adjusting Medicare Drug Price Negotiation Criteria May Increase Savings
Adjusting eligibility criteria for Medicare prescription drug price negotiation under the Inflation Reduction Act to include drugs with biosimilars and allow for drug selection based on net spending...Sponsored Article
How a Consolidated Payments Platform Positively Impacts Payers
Healthcare payers and third-party administrators are facing increasing challenges with complex and outdated technology infrastructures while keeping pace in a competitive marketplace. Technology...Employees Turn to Health Savings Accounts to Manage Healthcare Costs
Employees—particularly in younger generations—are investing in health savings accounts to manage their healthcare spending and find their employer-sponsored health plans are not enough to...Vertical Integration Raises Spending for Medicare Advantage Plans
Owning related businesses was associated with higher healthcare expenditures for Medicare Advantage plans, pointing to some of the consequences of vertical integration, a report from the USC-Brookings...How Overall, Out-of-Pocket Costs of Obesity Escalated in 10 Years
Obesity was linked to higher healthcare spending and higher out-of-pocket costs for individuals in employer-sponsored health plans, according to a Peterson-Kaiser Family Foundation (KFF) Health System...MA Beneficiaries Satisfied With Coverage but Face Financial Barriers
Medicare Advantage beneficiaries face more financial barriers than Medicare Supplement beneficiaries, but plan satisfaction is high for both groups, an eHealth report found. The report reflects survey...Sponsored Article
The Critical Task of Assessing Healthcare Payment Infrastructure
Health plans and third-party administrators (TPAs) face increasingly stiff competition in today’s payer marketplace. According to a recent American Medical Association study of health insurance...CA VBID Program Boosted Primary Care Use, Contained Healthcare Costs
California’s value-based insurance design (VBID) program was associated with a higher probability of primary care use, a lower probability of inpatient admissions, and no change in total costs...Humana Shares Data on Economic Contributions in Florida
Throughout 2022, Humana provided a high level of financial support to the state of Florida, taking responsibility for many jobs and a large share of wages and taxes. Recent news from Humana...How Medicaid Managed Care Orgs Can Better Invest in SDOH Interventions
Medicaid managed care organizations can leverage financial bonds to help increase funds for social determinants of health interventions and avoid underinvesting, according to research published in...Medicare Advantage Beneficiaries See Lower Hospitalization Rates
Medicare Advantage beneficiaries with ambulatory care sensitive conditions (ACSCs) experienced lower rates of hospitalizations but higher rates of emergency department (ED) direct discharges and...The Cost of Cancer Should Reflect Impacts on Wellbeing, Productivity
The cost of cancer goes beyond financial expenditures for adolescent and young adult patients, extending into mental health impacts and workplace productivity losses, according to a report...How the Inflation Reduction Act Impacted Medicare Part D Benefit Design
Medicare Part D plan liability could lead to major changes in benefits and formulary design for beneficiaries in the coming years, according to an Avalere study that was funded by PhRMA. The...Sponsored Article