As major payers like Centene and Cigna emerge from an atypical year, they are predicting in their fourth quarter 2020 earnings reports that revenues will increase in 2021, despite utilization and...
Major payer organizations, specifically America’s Health Insurance Plans (AHIP) and the Association for Community Health Plans (ACAP), are calling for a reversal on key Trump healthcare...
The recent executive order from the Biden administration represented a reversal in US healthcare policy that could have major implications for Medicaid and the Affordable Care Act...
Oklahoma has officially chosen four Medicaid contracts for its Medicaid managed care program known as SoonerSelect, according to state healthcare officials.
The state chose Centene, UnitedHealthcare,...
Uninsured Americans may not be examining all of their options in Medicaid or on the Affordable Care Act marketplace, a Robert Wood Johnson Foundation and Urban Institute study discovered.
In 2019, the...
The Biden administration has signed an executive order that sought to strengthen Medicaid and Affordable Care Act marketplace coverage and opened a special enrollment period on the Affordable Care...
Patient navigators in charge of helping consumers on the Affordable Care Act (ACA) marketplaces have a number of recommendations for successful enrollment periods during the pandemic and beyond,...
Medicaid expansion under the Affordable Care Act (ACA) led to increases in the identification of undiagnosed HIV infections and the use of HIV prevention services, according to new research out of the...
Six months after the public health emergency ends, states will need to have completed certain Medicaid eligibility and enrollment processes, CMS has indicated. They must prepare in advance in order to...
The Biden administration has chosen Liz Richter, the Deputy Center Director of CMS, to be acting CMS Administrator while the new president chooses an official appointee for the role.
As the...
CMS has approved a waiver for TennCare, Tennessee’s Medicaid program, which seeks to control Medicaid spending by implementing a block grant.
“The negotiated agreement includes the major...
CMS has finalized a rule which promotes private payers and states negotiating value-based purchasing contracts for Medicaid drugs, along with other changes.
The final rule was built upon the Medicaid...
States are increasingly relying on provider taxes and local government funds for their share of federal Medicaid payments according to a new Government Accountability Office (GAO) report. Officials are...
Medicaid cuts to address revenue shortfalls and budget deficits from COVID-19 could result in adverse long-term effects for children, according to an expanding body of research reviewed by The...
Overall healthcare spending in the US rose 4.6 percent in 2019 to hit $3.8 trillion, with private payers contributing a little more than three out of every ten healthcare dollars (31 percent), a recent...
Although utilization has started to return to normal levels, payers have continued making a profit during the third quarter of 2020, a Kaiser Family Foundation brief discovered.
“In this brief,...
As the 116th Congress comes to a close, America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield Association (BCBSA) urged legislators to provide COVID-19 relief, calling for access to...
To streamline care and improve quality monitoring, a new AHIP report calls for the expansion of states that contract with managed care organizations (MCO) to deliver Medicaid long-term services and...
States may need to re-evaluate their Medicaid managed care organization payment rates as trends of increased enrollment and low care utilization continue into fiscal year 2021, according to a Kaiser...
Healthcare coverage remains out of reach for many low-income Americans due to cost, but three innovative solutions for Connecticut might shed light on how to bolster payer coverage affordability, a...
