Public Payers News

Medicaid Expansion May Improve Maternal Health Outcomes, Coverage

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Policymakers may be able to improve maternal health and healthcare coverage around the time of pregnancy through Medicaid expansion, according to a recent Health Affairs report. The researchers used...

CMS: KY, ME, NM Will Launch State-Based Marketplaces in 2022

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Three states will launch their own state-based marketplaces in 2022, the Department of Health and Human Services (HHS) announced through CMS. Kentucky, Maine, and New Mexico will each bring have their...

Top Payer Strategies for Overcoming Coronavirus Vaccine Hesitancy

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As payers continue to search for answers to overcoming coronavirus vaccine hesitancy, safety net health plans in the Association for Community Affiliated Plans (ACAP) have consolidated their most...

275K Missourians Eligible for Coverage Following Medicaid Expansion

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Following Missouri’s approval for Medicaid expansion, more than 275,000 individuals are eligible for healthcare coverage, CMS reported. Missouri will receive around $968 million from the...

Payers Share Benefits Before Medicare Advantage Open Enrollment

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As the 2022 Medicare Advantage open enrollment period approaches, payers are revealing their 2022 Medicare Advantage benefits. Five major payers shared the updates to their benefit offerings for the...

2022 Medicare Advantage Premiums Drop, Enrollment May Rise

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Updated 9/30/21: This article has been updated to include a correction from Better Medicare Alliance. A previous version read "we urge lawmakers to project these gains," but this has been...

Uninsured Adults Remain Unaware of ACA Coverage, Subsidy Options

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Despite the White House’s efforts to increase awareness about Affordable Care Act marketplace health plans, uninsured adults are still largely unaware of their coverage options, according to...

OIG: Medicare Advantage Plans Improperly Used Chart Reviews, HRAs

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Some Medicare Advantage plans may have improperly used chart reviews and health risk assessments to maximize risk-adjusted payments from CMS, a report from the Office of Inspector General...

Medicare Advantage Double Bonus Payments Boost Racial Disparities

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Black beneficiaries are less likely to live in counties with a high enough Medicare Advantage quality performance to be eligible for Medicare Advantage double bonus payments, a Health Affairs report...

Expanding Covered Medicare Benefits May Lower Out-of-Pocket Costs

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Policymakers are looking to include dental, hearing, and vision benefits to Medicare as a part of the budget reconciliation bill, which could benefit many Medicare beneficiaries who go without this...

CMS Makes Changes to Open Enrollment Period, Introduces New SEP

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CMS has taken several steps to improve and expand access to healthcare coverage, including extending the open enrollment period for the Affordable Care Act marketplace. The agency added 30 days to the...

BMA Asks Congress to Secure Medicare Advantage Benefits in Reform Bill

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Better Medicare Alliance has commended Congress for including additional benefits in its proposed Budget Reconciliation plan for Medicare reform and is urging lawmakers to maintain the structure that...

Affordable Care Act Marketplace Sees Boost in Diversity, Savings

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HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace...

How to Expand Access to Coverage for Former Foster Children

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The Affordable Care Act’s protections for former foster children has increased access to coverage for foster youths, a particularly vulnerable population, according to a study published by Health...

Downstream Impacts of Making American Rescue Plan Act Permanent

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Making the American Rescue Plan Act permanent could lower costs on the Affordable Care Act marketplaces and eradicate the Medicaid coverage gap, but it would also cost the federal government up to $333...

Medicare Mortality Rates Reveal COVID-19 Racial Care Disparities

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While racial care disparities in Medicare are not new, the gap in mortality rates between beneficiaries of different ethnicities and races grew even more pronounced during the coronavirus pandemic, a...

Medicaid Subscription-Based Payment Models Show Mixed Results

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Using a subscription-based payment model to cover medication costs could have varying impacts on access to medication depending on the state that implemented the model, according to a study published...

CMS Guidance Promotes COVID-19 Vaccine Coverage, Medicaid Expansion

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The Biden Administration and CMS have released guidelines that detail federal funding information relating to Medicaid expansion and COVID-19 testing and vaccine administration for Medicaid and...

How States Leveraged COVID-19 Medicaid Emergency Authorizations

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COVID-19 Medicaid emergency authorization usage has differed most from past crises in regards to states’ utilization of Section 1115 demonstration waivers, according to a Kaiser Family Foundation...

Highmark Will Distribute $12.3M in Affordable Care Act Rebates

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Highmark Blue Cross Blue Shield Delaware will distribute more than $12.3 million in Affordable Care Act rebates, the state’s insurance commissioner announced. “With decreased utilization...