Member experience in the US healthcare system is fraught with challenges, but there are steps that policymakers can take to reduce out-of-pocket healthcare costs and make navigation more amenable,...
Employer-sponsored health plan costs rose in 2021, but access to employer-sponsored insurance also increased as more private-sector businesses offered coverage, according to a report from the State...
Medicare Advantage enrollment has grown in the last decade largely due to an influx of Black, Hispanic, and low-income beneficiaries, a research letter published in the JAMA Health Forum found.
Before...
Tailored care and streamlining payment and insurance functions can help improve families’ experiences with special needs care for children with special needs, according to UnitedHealth...
The maximum out-of-pocket limit in Affordable Care Act (ACA) marketplace plans is rising faster than enrollee wages and salaries, a Peterson-KFF Health System Tracker found.
Researchers used data from...
Family income is a significant factor in the levels of out-of-pocket and catastrophic spending on insulin among insulin users, a study published in Health Affairs found.
The researchers leveraged 2017...
As payers finalize premiums for 2023 for the individual market, 2023 individual health insurance market premiums will be subject to a variety of factors, according to an issue brief from AHIP.
The...
Medicare Advantage plans are seeing low healthcare spending, strong diversity, and high enrollment in 2022 compared to 2021 and earlier years, according to the Better Medicare Alliance’s 2022...
UnitedHealthcare has announced that it will eliminate out-of-pocket healthcare costs for insulin and other emergency use drugs for fully insured group health plan members.
Members will be able to...
Under Medicare Part D, more than half of the beneficiaries were liable for paying the entire out-of-pocket cost of their generic prescription drug, according to an analysis from Avalere.
Avalere...
Employer-sponsored health plan coverage is not common among employees who face a higher risk of workplace injury, a Value Penguin study revealed.
The study relied on data from the US Census...
The expiration of the American Rescue Plan Act (ARPA) premium subsidies and the return of Medicaid redeterminations will likely result in 2023 premium rate changes for individual and small group health...
Health insurance premiums absorb a high share of the average American’s annual income and must compete with other essential expenses to be a priority in consumers’ minds, a study from...
Health savings accounts were designed to create a more healthcare cost-conscious populace, but research indicates that these plans may fail to support that goal, according to an analysis published in...
The US Department of Health and Human Services (HHS) has released a fact sheet elucidating the fallout of the impending American Rescue Plan’s premium subsidy expiration, including higher...
By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase...
Applying an out-of-pocket spending cap to Medicare Part D could be a tool for promoting health equity, according to an insight from Avalere.
Avalere researchers leveraged 2019 Medicare Part D Drug...
Out-of-pocket costs may dissuade Medicare beneficiaries from initiating treatment with high-price Part D specialty drugs, as beneficiaries without low-income subsidies were less likely to fill a new...
Certain utilization management techniques—such as step therapy and prior authorization—may increase employees’ costs and restrict access to care, especially for employees with chronic...
Policymakers should consider increasing access to and promoting the use of biosimilars and monitoring trends in biosimilar coverage in order to bring down Medicare Part D spending, the Office of...
