Billions in overspending on medical costs are attributed to social determinants of health (SDOH), and SDOH can identify if beneficiaries covered by insurance plans are at risk for adverse health...
UnitedHealthcare Community Plan of Wisconsin awarded four non-profit community health organizations a total of $100,000 to enhance healthcare access and resources for individuals with...
The Humana Foundation announced awards totaling $735,000 to help South Florida nonprofits to help improve community health.
As part of the payer’s philanthropic pursuits, the grants are being...
A significant rollback of Medicaid coverage in Tennessee has led to a spike in late stage diagnosis for breast cancer, according to a new data analysis published in the American Cancer Society journal...
Due to legal and financial reasons, the past several decades have seen LTSS move from institutional settings to home or community based care, increasingly adopting the use of MCOs. As states...
The CMS office of Minority Health released a report with data on the quality of care received by Medicare Advantage (MA) enrollees by gender in four ethnic or racial categories.
The data...
Kentucky’s Anthem Blue Cross and Blue Shield Kentucky Medicaid has received an award from the National Committee for Quality Assurance (NCQA) for its Medicaid managed care plan.
The award...
In a letter sent to Senate leadership, American College of Cardiology President Mary Norine Walsh, MD, advised lawmakers to ensure access to “meaningful insurance coverage and quality,...
To reduce payer claim costs, would you pay members to go see their doctor once a year? That’s the premise for a wave of patient incentive programs currently being offered by health...
To circumvent an obscure Medicaid requirement, seven more states applied to join California, Maryland, Massachusetts and New York to receive a Medicaid waiver to expand drug addiction...
Despite financial penalties designed to prompt consumers to keep their health insurance, current efforts to subsidize care for low-income individuals may not be enough to incentivize patients,...
The National Association of Insurance Commissioners (NAIC) issued ten long term care (LTC) federal policy recommendations to Congress. The report was completed as part of the group’s...
Rhode Island will add Tufts Health Plan (THP) as its first new Medicaid option in seven years, according to the Rhode Island Executive Office of Health & Human Services (EOHHS). The new...
Blue Cross-Blue Shield of Michigan has one of the nation’s most successful patient-centered medical home (PCMH) networks. The model has improved patient outcomes, lowered payer costs and...
A new report by the Commonwealth Fund found that Medicaid provides equal or better quality health coverage to private health insurance plans.
The Commonwealth Fund’s 2016 Biennial Health...
Health insurance payers can improve patient outcomes and reduce spending by expanding the use of population health management models for expectant mothers. Early intervention and preventive care...
Insufficient control of opioid prescriptions is one of the key reasons why opioid abuse and addiction have risen dramatically over the past few years. To mitigate the epidemic, payers...
CMS will continue to take public comment on its pediatric alternative payment model (APM) initiatives until April 7, 2017.
In March, CMS issued a request for information (RFI) related to...
The Network for Excellence in Health Innovation (NEHI) believes that developing value-based purchasing contracts between payers and pharmaceutical companies will be a critical next step for healthcare...
The New Jersey Health Care Quality Institute (NJHCQUI) recently partnered with the Nicholson Foundation to release a 25-point plan for modernizing and improving New Jersey’s Medicaid...
