The Department of Justice (DOJ) has announced that it will approve the proposed merger between CVS and Aetna as soon as Aetna completes the divestiture of its Medicare Part D business line.
Two...
Healthcare payers are beginning to launch partnerships with trade organizations and chambers of commerce to provide association health plans (AHPs) to small businesses and contractors.
The roll out of...
Managed care payers and state Medicaid agencies are finding it difficult to find personnel to administer long-term support services (LTSS) within home and community-based settings (HCBS), says a new...
Telehealth offers a cost-effective way to improve member satisfaction with benefits and support meaningful chronic disease management, according to a new report from AHIP and the Coalition to Transform...
With more than one out of every three Americans living with prediabetes, payers are actively seeking out innovative strategies for preventing progression of the costly and life-changing disease....
Managed care payers can use data analytics, case management strategies, and patient engagement tools to address the needs of high-risk individuals with substance use disorders (SUDs), states a new...
Mobile apps, enrollment platforms, and search engines help the majority of consumers prepare for open enrollment and make informed healthcare choices, says a new survey from...
Just under half of employers participating in a survey from the National Business Group on Health (NBGH) are actively experimenting with innovative health plan designs that aim to foster new approaches...
The National Committee for Quality Assurance (NCQA) has selected four health plans to test a new performance standard for collecting patient-reported outcomes measures, or PROMs.
NCQA’s...
Health plans that offered high-quality preventive care and comprehensive chronic disease management received top marks in the latest health plan rankings from the National Committee on Quality...
Investment in high-performance narrow networks, creating new payment incentives, and leveraging digital innovation could help to increase adoption of value-based payment reform across the healthcare...
Adopting new payment models, engaging in targeted risk scoring, and improving prior authorization processes may help payers address medication-non adherence among members with mental health concerns,...
Payers will need to take the lead in being transparent about healthcare quality and costs in order to improve patient safety and reduce unnecessary spending, experts told the Senate HELP...
Medicare and Medicaid dual-eligible care models provide extensive care coordination to ensure beneficiaries with multiple chronic conditions can access healthcare services, according to a new AHIP...
Reference pricing models for prescription drugs may help to contain spending and reduce high costs for beneficiaries, says a new report from the Commonwealth Fund.
Currently, most payers use tiered...
BlueCross BlueShield of Michigan has reduced expected spending by $626 million over a nine-year period through a patient-centered medical home (PCMH) model that emphasizes personalized care.
The payer...
More comprehensive coverage for mental healthcare could bring a financial return of four dollars for every one dollar spent by employers, says a report from the National Alliance of Healthcare...
Widespread rates of poor consumer literacy within the healthcare industry creates administrative burdens for payers and contributes to an additional $4.8 billion in health plan costs, according to a...
Cigna will invest $250 million in the new Cigna Ventures fund, which will invest in healthcare startups specializing in analytics, digital health, retail, care management, and other business...
FDA has launched a new quality assurance program that leverages feedback from commercial payers about medical device coverage requirements in order to expedite approvals.
The Private Payor Program...