Payers are spending billions of dollars annually on medications that aren’t improving the health outcomes, with financial and health literacy proving to be the most common barriers to...
As payers explore innovative ways to improve beneficiary engagement and satisfaction, they may wish to consider adding enhanced consumer wellness benefits to their health plan offerings.
Health plans...
The federal health plan market contracted under the Office of Personnel Management (OPM) has remained heavily concentrated over the last decade, despite OPM’s efforts to improve health plan...
As payers try to ease the rising costs of prescription drugs, which account for 10 percent of national healthcare spending, they may wish to turn to the generic drug market to help curb unnecessary...
Increasing pricing transparency around generic drugs could offer significant advantages to payers, including lower prices and more favorable reimbursement negotiations, according to a report from USC...
ACA federal reinsurance policies have undergone a transformation since their introduction from four years ago. Payers should continue to prepare for larger changes of federal and state ACA reinsurance...
Anthem BlueCross BlueShield plans to add value onto consumer Medicare Advantage (MA) plans by offering personal emergency response systems (PERS) to beneficiaries, the payer announced in a series of...
Value-based pharmaceutical contracting offers health payers the option to lower drug prices while improving patient outcomes.
These contracts come in several different forms, according to Dr. Surya...
AHIP launched the Safe, Transparent Opioid Prescribing (STOP) Initiative to support health plans’ widespread adoption of clinical guidelines for pain care and opioid prescribing, and combat the...
Medicare Advantage (MA) market data from A.M Best and the Kaiser Family Foundation reveals that the MA market has remained profitable and provides financial opportunity, but payers looking to enter...
Mercy Health of Arkansas and the Centene Corporation have received approval to operate an accountable care organization within the state focusing on Medicaid beneficiaries, the organizations announced...
Only 30 percent of employers have a complete understanding of their pharmacy benefit manager (PBM) contracts, according to a new survey from the National Pharmaceutical Council (NPC).
Just 40 percent...
Payers have significant control of their respective healthcare markets as 69 percent of payers offering HMO, PPO, POS, and public health exchanges operate in very high concentrated markets, AMA found...
Medicare consumers tend to prefer traditional phone calls or mailings over digital engagement strategies such as text messaging or using a member portal, according to a new Healthmine...
Anthem is offering home meal delivery service to its post-discharge Medicare Advantage plan members in in several states including Georgia, Kentucky, Missouri, and Wisconsin the payer...
In an increasingly competitive health insurance environment, payers that can successfully increase consumer engagement and beneficiary satisfaction will be best positioned for success.
David Biel, the...
Payers have been increasingly challenged to manage the high cost of healthcare while lowering the premiums their beneficiaries pay. Creating balanced risk pools that benefit medically complex...
Growth in employer-sponsored insurance enrollment and certain measures of member engagement did not significantly increase in 2015 and 2016, according to the Medical Expenditure Panel Survey (MEPS)...
High-deductible health plans (HDHPs) may reduce spending, but are also prone to preventing health care consumers from accessing necessary services and recommended preventive care, according to a study...
Health plans may not be effectively communicating with consumers about member benefits and largely fail to understand their members’ health and financial needs, a survey from Healthmine...
