Centene and Ascension have partnered to offer a Medicare Advantage plan across multiple geographic markets in 2020.
Centene Chairman and CEO Michael F. Neidorff believes that the partnership...
CAQH CORE is urging healthcare payers, providers, and other stakeholders to promote industry-wide collaboration on how to improve prior authorizations.
Leading provider and payer organizations,...
Medicare Advantage is a growing market and an attractive opportunity for payers to offer quality plans to older beneficiaries. Competition is increasing in the MA environment, and beneficiaries...
Only 10 percent of Medicare Advantage (MA) and Medigap plan members receive chronic care management reminders,, according to a new survey from Healthmine.
The CDC estimates that 70 percent of all...
A commercial shared savings program equipped with the right leadership, clinical insights, and comprehensive care strategies can help payers save significantly on healthcare costs and produce...
Rhode Island officials have requested an extension of a 1115 demonstration from CMS to expand the use of value-based care within the state’s Medicaid program.
State Medicaid administrators are...
Medicare Advantage (MA) and Medicare supplemental insurance, or Medigap, are both intended to enhance the value of traditional Medicare coverage for seniors and other eligible beneficiaries.
Both...
Health plans offered through the Small Business Health Options Program (SHOP) exchanges allow payers to provide the nation’s smallest businesses with affordable plan options that offer critical...
Leveraging the data of all-payers claims databases (APCDs) could improve healthcare price transparency for consumers, according to testimony presented at a House Energy and Commerce Committee...
The number of employer-sponsored stop-loss insurance claims of $1 million or more grew by 87 percent from 2014 to 2017, according to a new analysis from Sun Life Financial.
Over the four-year period,...
The Healthcare Effectiveness Data and Information Set (HEDIS) provides 90 percent of America’s health plans with the ability to directly compare performance across the national stage....
The BlueCross BlueShield Association has announced a new accreditation program for opioid abuse treatment centers as a larger part of the organization’s mission to combat the US opioid...
The Medicare Advantage (MA) program has surpassed Medicare fee-for-service (FFS) in developing positive member healthcare outcomes and reducing care costs, according to an analysis of both programs...
Health plan cost sharing and deductible spending have outpaced employee wage growth in the last ten years, according to data released by the Peterson-Kaiser Health System Tracker.
Employees’...
Medicare Advantage (MA) health plans with a greater proportion of socioeconomically challenged members are more likely to have lower star ratings, according to new research from Brown...
The National Committee for Quality Assurance (NCQA) has released updates to its HEDIS performance measures for plan year 2019. The refresh includes several new measures to guide population health...
Providing extended home health benefits for Medicare beneficiaries is likely to stabilize care costs for public payer programs, according to a new analysis from the Commonwealth Fund.
Researchers from...
Highmark BlueCross BlueShield has saved $260 million in avoidable care costs by using value-based reimbursement and provider performance standards to hold healthcare organizations accountable for...
Retail clinics are gaining in popularity among patients looking for quick, convenient care for minor ailments.
Kiosks and no-appointment-needed offices located in corner pharmacies and big box stores...
Partners HealthCare has announced it will self-insure 100,000 of its employees, transitioning coverage from BlueCross BlueShield of Massachusetts to its own Neighborhood Health Plan, according to The...