Private Payers News

Employees Lack Health Insurance Enrollment Knowledge, Support

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While many employees consider themselves knowledgeable about health insurance enrollment, their responses to various questions about general health insurance questions would indicate otherwise,...

SCAN Health Plan Announces Medicare Advantage Expansion into TX

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SCAN Health Plan (SCAN) announced it will be extending Medicare Advantage plans into Texas and new counties in Nevada in 2023. “As SCAN continues to grow and build its national reputation as a...

How Long COVID Could Impact Health Insurance Coverage, Eligibility

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The presence of long COVID may spur changes in health insurance coverage, as people with employer-sponsored health plans may have to cut back their hours or stop working, according to data from the...

Humana Receives Top Ranking for Health Plan Member Experience

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For the second year in a row, Humana has ranked number one for customer experience quality in Forrester’s 2022 US Customer Experience Benchmark survey, highlighting the payer’s commitment...

UHG Data Shows Impact of Telehealth on Outpatient Behavioral Health

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Telehealth flexibilities during the coronavirus pandemic contributed to a 26 percent spike in overall utilization of in-network outpatient behavioral health, according to a report from UnitedHealth...

Aetna CVS Health Intends to Enter CA Individual Health Insurance Marketplace

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Aetna CVS Health announced that it plans to enter California’s individual health insurance marketplace. “With millions of Americans being uninsured or underinsured, our plans provide...

Cigna Extends Medicare Advantage Transportation Benefit Due to Heat

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Cigna is expanding its Medicare Advantage transportation benefit to bring Medicare Advantage members to locations where they can avoid the extreme heat. “Older adults tend to be more susceptible...

UHG Initiative for Children with Special Needs Boosts Net Promoter Score

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Tailored care and streamlining payment and insurance functions can help improve families’ experiences with special needs care for children with special needs, according to UnitedHealth...

Aetna Medicaid Plan Recognized by NCQA for Health Equity Efforts

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Aetna’s Medicaid plan in California, Aetna Better Health of California, has received the National Committee for Quality Assurance’s (NCQA) Multicultural Health Care Distinction,...

Data Shows Lack of Health Equity in Employer Sponsored Health Plans

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Data on employees continues to exhibit care disparities that signal a lack of health equity in employer-sponsored health plans, according to a report from NORC at the University of Chicago (NORC)...

Medicare Advantage Plans See High Enrollment, Low Spending in 2022

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Medicare Advantage plans are seeing low healthcare spending, strong diversity, and high enrollment in 2022 compared to 2021 and earlier years, according to the Better Medicare Alliance’s 2022...

UnitedHealthcare Cuts Out-of-Pocket Healthcare Costs for Insulin

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UnitedHealthcare has announced that it will eliminate out-of-pocket healthcare costs for insulin and other emergency use drugs for fully insured group health plan members. Members will be able to...

Workers in Injury-Prone Industries Lack Employer-Sponsored Health Plans

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Employer-sponsored health plan coverage is not common among employees who face a higher risk of workplace injury, a Value Penguin study revealed. The study relied on data from the US Census...

UHG Makes $25M Social Determinants of Health Donation To Housing Fund

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UnitedHealth Group has dedicated $25 million toward a fund that will bolster development projects for mixed-income housing to address social determinants of health in New England. The fund is called...

Consumers Continue to Experience Surprise Billing After No Surprises Act

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Although the No Surprises Act went into effect at the beginning of 2022 to protect consumers from receiving unexpected healthcare bills, consumers have reported that they continue to be affected by...

2% of ACA Marketplace In-Network Claims Denials Are for Medical Necessity

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Given the 18 percent denial rate for in-network claims in 2020, payers on the Affordable Care Act marketplace should offer more robust transparency around data reporting for in-network claims denials,...

Aetna Takes Action to Enhance Adolescent Suicide Prevention

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CVS Health and its payer arm, Aetna, will expand its existing program with Psych Hub, advancing its efforts around adolescent suicide prevention. Over the last several years, the number of teens...

UHC Adds Health System to CO Doctor Plan to Boost Patient Care Access

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HealthONE, the most extensive Denver-based healthcare system, announced it would be joining the UnitedHealthcare Doctors Plan of Colorado, expanding its network size to enhance patient care access. By...

Payer Recognized for Health Equity, Social Determinants of Health Efforts

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Health Net has been recognized in an Institute for Medicaid Innovation (IMI) report for the payer’s work in health equity, along with various other stakeholders that have made progress on...

Employer Sponsored Health Plans Generate Significant ROI, Benefits

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Employer-sponsored health plans will generate a 47 percent return on investment (ROI) for employers in 2022, mainly driven by reduced direct medical costs, higher productivity, and tax benefits,...