Private Payers News

SCAN Health Plan Reports Decline in COVID-19 Vaccine Disparities

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SCAN Health Plan has announced a significant decrease in coronavirus vaccine disparities. “SCAN is committed to eliminating the troubling disparities in the health care system that...

Tracking Social Determinants of Health Data in Medicare Advantage

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Gathering social determinants of health data continues to be a challenge for Medicare Advantage health plans, according to a report that NORC at the University of Chicago (NORC) compiled for Better...

Top Trends In Small Business Health Insurance During COVID-19

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Small business health insurance gravitated toward level-funding and self-funding and did not shift toward significantly toward the individual health insurance marketplace during the coronavirus...

Payer Financially Supports Diversity in Mental Healthcare Workforce

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Blue Shield of California (Blue Shield) is donating $500,000 to a nonprofit internship program in an effort to help diversify the behavioral and mental healthcare workforce. Health Career Connection...

DOJ Intervenes in Whistleblower Cases Alleging Medicare Fraud

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The Department of Justice (DOJ) will intervene in the case of six whistleblower lawsuits against Kaiser Permanente regarding Medicare Advantage diagnosis codes and alleged Medicare fraud. The lawsuits...

2022 Marketplace Rate Filings Show Few Pandemic-Related Increases

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Based on 75 individual marketplace rate filings, the coronavirus pandemic is not expected to meaningfully affect healthcare spending in 2022, a Peterson-Kaiser Family Foundation (KFF) Health System...

What Employees Want in Their Employer-Sponsored Health Benefits

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Employees are looking for employers to bolster preventive care services, mental healthcare, and access to employees’ providers in their employer-sponsored health benefits, a Marathon Health...

UHC Funds Community-Based Social Determinants of Health Efforts

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UnitedHealthcare is aiming to address social determinants of health and increase access to care by granting $11.4 million to community-based organizations throughout the country. As a part of its...

Cigna + Oscar Extends Virtual Primary Care Plan 2022 Footprint

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Cigna and Oscar Health, Inc are expanding their virtual primary care program to Tennessee and Georgia in order to increase access to care for small business owners and employees. Pending regulatory...

Arkansas Blue Cross Grants $5M to Improve Behavioral Healthcare

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Arkansas Blue Cross is allocating $5.29 million to behavioral health programs in Arkansas to help increase access to behavioral healthcare services amid the ongoing mental health crisis in the...

Employer-Sponsored Health Plans Spent $814B on 2019 Benefits

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Employer-sponsored health plans spend over $5 on healthcare benefits for every $1 lost in tax revenue due to tax exemptions, which demonstrates the advantages of employer-sponsored health plans for...

Anthem, Kroger Health Partner To Offer Medicare Advantage Plans

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Anthem Blue Cross and Blue Shield (Anthem) and Kroger Health have announced that they will be partnering to offer a Medicare Advantage plan in 2022, an Anthem spokesperson told HealthPayerIntelligence...

Payer Moves to Increase Member Access to Acute Home Healthcare

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Regence BlueShield (Regence) has partnered with a home healthcare provider to increase member access to acute home healthcare services. Regence members in Pierce County, Washington will have access to...

Community First Expands into TX Affordable Care Act Marketplace

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Community First Health Plans (Community First) is joining the Affordable Care Act (ACA) marketplace with the help of a member engagement technology company. The payer’s move to join the...

How Employer Health Benefits Are Changing Due to Coronavirus

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As the country emerges from the coronavirus pandemic, employer health benefits will be more focused on investing in mental healthcare needs and will reduce the prominence of physical wellness programs,...

How Proficiency in Speaking English Impacts Healthcare Spending

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Whether or not a member can speak English fluently may influence their healthcare spending, a recent Health Affairs study uncovered. From 1999 to 2018, researchers estimated that the number of...

Aetna Prior Authorization Policy Takes Effect, Providers Protest

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Updated 7/08/2021: This article has been updated to include a comment from an Aetna spokesperson. Ophthalmologists are responding in opposition to Aetna’s new prior authorization policy for...

Payer COVID-19 Vaccine Outreach Program Vaccinates 2M Seniors

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AHIP and the Blue Cross Blue Shield Association (BCBSA) have helped over two million seniors receive the COVID-19 vaccine through their vaccine outreach program. The Vaccine Community Connectors (VCC)...

Medicare Supplemental Coverage Tied to Fewer Cost-Related Hurdles

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Medicare Advantage beneficiaries experience higher rates of problems related to healthcare spending compared to traditional Medicare beneficiaries who have Medicare supplemental coverage, according to...

Behavioral Healthcare Parity Is Low Among Regional, State Plans

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Although the coronavirus pandemic has imposed significant changes on the healthcare industry particularly in regards to behavioral and mental healthcare, historically behavioral healthcare parity has...