LA Care Health Plan is combatting the provider workforce shortage and improving access to care by issuing provider recruitment grants, the payer announced.
The payer is distributing $1.75 million...
The CMS national coverage determination for the Alzheimer’s drug Aduhelm, or aducanumab, may fail to support health equity, as underrepresented populations may have limited access to clinical...
In general, Medicaid managed care organizations (MCOs) have better provider network adequacy standards at the federal level than marketplace qualified health plans (QHPs), but standards varied...
Policymakers should consider increasing access to and promoting the use of biosimilars and monitoring trends in biosimilar coverage in order to bring down Medicare Part D spending, the Office of...
Medicare coverage for antiretroviral therapy (ART) did not improve overall spending for Medicare beneficiaries with HIV, but the therapy did appear to positively impact spending outside of HIV...
In a historic move, CMS has announced that Medicare Part B beneficiaries can receive full coverage for up to eight over-the-counter coronavirus tests in a calendar month during the coronavirus...
CalOptima—a county-organized health system that offers care through public payer coverage, including Medicaid, Medicare Advantage, and Medicare-Medicaid plans—is launching a five-year...
CMS has released its projections for national healthcare spending from 2021 to 2030, noting that healthcare as a share of the gross domestic product (GDP) will remain comparable to the share in...
States have four main tools at their disposal for managing risk in Medicaid managed care organizations, according to a MACPAC issue brief.
Medicaid managed care organizations are reimbursed in a...
If federal officials do not extend the enhanced premium subsidies under the American Rescue Plan Act (ARPA), state-based marketplace enrollees will face higher premiums and may lose coverage in 2023,...
As the public health emergency (PHE) nears an end, policymakers must consider expanding temporary public payer policies that improve person-centered care for beneficiaries, including telehealth and...
As the Affordable Care Act turns 12 years old, CMS and the Department of Health and Human Services (HHS) commemorate the law’s impact on the US healthcare system.
“On the...
The Affordable Care Act marketplace’s tobacco surcharge might decrease enrollment and dissuade tobacco users from entering the marketplace, according to a Health Affairs article.
Health plans on...
Overall, Medicare Supplement plan enrollment decreased slightly in 2020, but a select few plans continued to grow with nearly 90 companies offering plan policies, according to an AHIP report.
Medicare...
Over nine in ten counties boasted a medium- or high-quality health plan as their highest-rated plan on the Affordable Care Act marketplace in 2020, according to a Health Affairs article.
Researchers...
With misinformation about the public charge rule still circulating and affecting immigrants’ access to coverage, Medicaid programs, Affordable Care Act marketplace plans, and CHIP programs can...
CMS has released a national coverage determination draft for the Alzheimer’s drug, Aduhelm or aducanumab, but coverage limitations in the draft may create access to care challenges for seniors...
Low-cost behaviorally informed letters sent to individuals seeking healthcare coverage on HealthCare.gov helped increase Affordable Care Act (ACA) marketplace enrollment, a study published in JAMA...
The end of the coronavirus public health emergency declaration could lead to a shift in Medicaid spending for state Medicaid programs and federal Medicaid costs, according to a report from the Robert...
Medicaid spending grew to $116 billion on home and community-based services (HCBS) during fiscal year 2020, providing services to 3 million people through waivers and more than 2.5 million people...
