Private Payers News

UnitedHealthcare Vision, Dental Plans Lead in Customer Satisfaction

by

UnitedHealthcare’s vision and dental plans received the highest customer satisfaction scores in 2021, JD Power’s 2021 satisfaction reports found. Vision and dental plan overall...

Humana Expands Medicare Advantage Value-Based Contract in MN

by

Humana has announced a multi-year, Medicare Advantage value-based contract to extend access to value-based care for members in Minnesota. “This value-based agreement for Humana Medicare...

An Overview of 2021 Prescription Drug Benefits: Tiers, Cost-Sharing

by

In 2021, prescription drug benefits took many forms as employers and payers played with tier structures and cost-sharing strategies to help manage prescription drug costs for employees, a Kaiser Family...

The Status of High Deductible Health Plans with Savings Option

by

Updated 11/22/2021:  This article has been updated to correct a statistic in order to indicate that large firms on average contributed $16,132 to the employee premium and $937 to each...

Americans Ready To Choose Coverage During 2022 Open Enrollment

by

More than eight out of ten survey participants in UnitedHealthcare’s sixth annual Consumer Sentiment Survey indicated that they are ready to choose a health plan during 2022 open enrollment...

Teladoc, Trustmark Announce Virtual-First Health Plan

by

Trustmark Health Benefits (Trustmark), the employer-sponsored health benefits arm of Trustmark Mutual Holding Company, has announced that it will partner with Teladoc to form a virtual-first health...

Humana Announces Changes To Veteran Population Health Management

by

Humana has announced new efforts to improve veteran population health management. The payer will introduce the veteran community into its Bold Goal communities, giving them the same kind of population...

Payer Third Quarter Earnings Results Spotlight COVID-19 Impact

by

Payer third quarter earnings results indicated that the coronavirus pandemic had varying effects on major payers in 2021. For some payers, higher than expected levels of deferred care led to revenue...

Humana Type 2 Diabetes Reversal Program Leverages RPM, Nutrition

by

Updated 11/9/2021: This article has been updated to say that patients who lost weight due to the program lost on average 12 percent of their weight. A previous version stated that 12 percent of...

Step Therapy Protocols Vary By Health Plan, 55% Too Strict

by

For certain diseases, some payers implement step therapy protocols that are stricter than clinical and regulatory entities have recommended, researchers found in a Health Affairs study. “Step...

United Behavioral Health Sued for Restrictive Bundled Payment Policy

by

United Behavioral Health is being sued for allegedly denying mental healthcare and substance abuse care claims through its bundled payment policy. United Behavioral Health administers UnitedHealth...

Coronavirus Pandemic’s Impact on Insurer, Consumer Trends in 2021

by

The coronavirus pandemic has left its mark on health insurer and enrollee trends, an eHealth report confirmed. The report based its findings on over 2,200 anonymous survey responses from the American...

COVID-19 May Push Americans To Change Plans For Open Enrollment

by

Many consumers are considering changing their healthcare plan during open enrollment 2022, a movement largely motivated by the coronavirus pandemic, according to a ValuePenguin study.  The...

Aetna Will Offer Some Gene Therapies As Standard Medical Benefit

by

Aetna members will have better access to gene therapies in 2022, the payer announced. “Gene therapy is poised for significant growth in the coming years, and the promise of durable improvement...

More Employers Turn to Employer-Sponsored Primary Care Clinics

by

Employer-sponsored primary care clinics are a steadily growing trend among large employers and one that experts anticipate to persist as a result of the coronavirus pandemic, according to a study...

CVS Health to Offer Coverage for Moderna COVID-19 Booster Shot

by

CVS Health has announced that it will offer Moderna COVID-19 booster shots to eligible individuals at more than 9,800 pharmacy locations. The CDC, following guidance from the Advisory Committee on...

Members Find Private Payer Mental Healthcare Networks Inadequate

by

Private health plan members have found that payers’ mental healthcare networks are less adequate than their medical health networks, a study published in the JAMA Network Open revealed. There...

Most Payers Are Unfamiliar with Prescription Digital Therapeutics

by

Prescription digital therapeutics (PDTs) coverage remains nascent, as the adoption rate is only at 40 percent among the minority of payers who have familiarity with PDTs, according to a survey that...

UnitedHealthcare Targets Prenatal Care, Maternal Health Outcomes

by

UnitedHealthcare (UHC) has provided $175,000 to medical practice UWH of North Carolina to support group prenatal care and boost maternal health outcomes for pregnant people across the state. UWH of...

More Medicare Advantage Plans Offer SDOH Benefits With $0 Premium

by

More Medicare Advantage health plans will deliver social determinants of health and non-medical supplemental benefits in 2022 and the existence of $0 premium plans continues to grow, an Avalere study...