Private Payers News

Blue Cross MN Partnership Expands Value-Based Care for Rural Members

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Blue Cross and Blue Shield of Minnesota (Blue Cross) has joined forces with value-based care provider Homeward to expand access to care for Medicare Advantage members living in rural Minnesota...

Humana Will Leave Employer Group Insurance Business to Focus on Public Plans

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Humana has announced plans to leave the employer group insurance business and direct its focus toward its government-funded health plan offerings. The payer’s employer group commercial medical...

Why Employers Prefer Employer-Sponsored Health Plans Over Exchanges

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Large employers find that employer-sponsored health plans allow them to maintain control over employee health plan choice and healthcare spending in order to streamline coverage for their workforces,...

2022 Key Enrollment Trends For High Deductible Health Plans

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High deductible health plan (HDHP) enrollees may have a broader selection of health plans and may view pre-deductible coverage for chronic disease prevention care as a deciding factor in health plan...

BCBST Report Reveals Racial Care Disparities Among TN Residents

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BlueCross BlueShield of Tennessee (BCBST) has published its first health equity report, revealing the racial care disparities that Tennessee residents face in behavioral healthcare, maternal...

Best Vendors for Healthcare Payer Services, Software Needs

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As the US enters a post-pandemic era with the end of the public health emergency, healthcare payers will want to choose the right partners to take them into the next stage. They might locate new...

Indiana Payer Partners with Provider Org to Boost Primary Care Access

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Physicians Health Plan of Northern Indiana (PHP) is looking to improve primary care access for members by partnering with healthcare provider Premise Health to open a primary care center for clients...

Employer-Sponsored Health Plans Pay More for Drugs than Medicare

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Employer-sponsored health plans paid more than Medicare for most physician-administered drugs with the highest use and the highest spending, according to data published in JAMA Health Forum. In...

New Humana Community Partnerships to Strengthen Health Equity

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Humana, and its philanthropic arm, the Humana Foundation, have advanced its commitment to health equity by unveiling an advanced strategy that focuses on addressing social determinants of health (SDOH)...

Out-of-pocket Costs for Opioid Use Disorder Treatment Varied by Payer

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Out-of-pocket costs for buprenorphine prescriptions for opioid use disorder treatment decreased between 2015 and 2020, but costs varied by payer, according to a study published in JAMA Network...

Centene Managed Care Plans Will Pay Medi-Cal $215M for Overcharges

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Centene must pay Medi-Cal, California’s state Medicaid program, over $215 million to settle allegations that it two of its managed care plans overcharged the program by reporting inaccurate...

High Deductible Health Plan Enrollment Hit Record High in 2021

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High deductible health plan (HDHP) enrollment hit a record high in 2021, with nearly six out of ten employer-sponsored health plan members enrolled in a high deductible health plan, according to a...

Humana Maintains Primary Care Access for Medicare Advantage Members

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Humana has signed a five-year agreement with ChenMed, solidifying access to in-network, senior-focused primary care for Medicare Advantage members. The agreement continues the decades-long...

Most Employers Will Enhance Services to Improve Employee Wellbeing

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Nearly nine in ten employers plan to adjust their vendor partnerships over the next two years to improve employee wellbeing benefits, according to a survey from Willis Towers Watson (WTW). The survey...

Employers Emphasize Quality of Care When Assessing Health Plans

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Two big shifts occurred among employers between 2020 and 2022: more employers reported that their health plans shared safety and quality of care data and more employers did not find their health...

ACHP Addresses Proposed Rule on Substance Use Disorder Patient Data

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The Alliance of Community Health Plans (ACHP) was among around 50 organizations—including AHIP and Blue Cross Blue Shield Association—to sign a letter to HHS that supported fully aligning...

Health Savings Account Balances, Contributions Grew in 2021

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The average health savings account (HSA) balance increased in 2021, with most account holders contributing more money than they withdrew, according to a report from the Employee Research Benefit...

Aetna Funding Improves Healthcare Access for Domestic Violence Survivors

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Aetna’s Children’s Health Insurance Program (CHIP) organization, Aetna Better Health Kids, has contributed $50,000 to help increase access to trauma-informed, affordable healthcare for...

Cigna’s Integrated Health Plan Reduced Care Costs for Employers

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Employers saved more than $1,400 per member per year when employees enrolled in Cigna’s integrated health plan that coordinates medical, pharmacy, and behavioral benefits, according to a study...

Employer-Sponsored Health Plans Face High Costs for SUD Treatment

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Employer-sponsored health plans paid $35.3 billion to cover substance use disorder treatments in 2018, a recent study published by JAMA Network Open found. The researchers used Merative MarketScan...