America’s Health Insurance Plans (AHIP) has announced new online resources for the public to help consumers understand their health plan options during the Affordable Care Act special enrollment...
Members ask themselves three questions when considering their own mental healthcare needs, according to Cara McNulty, president of behavioral health and the Employee Assistance Program at...
Self-funded employers take on the responsibility of covering their employees’ medical costs.
The strategy is particularly appealing for large employers because they can exert more control over...
Payers have the power to influence low-value care spending in a meaningful way.
However, recent data has unveiled the reality that low-value care remains prominent in certain health insurance...
As gene therapies become more widespread, payers continue to rely on proven strategies to reduce gene therapy healthcare spending, CVS Health’s Health Trends Report 2021 explained.
The report...
While payers have been focusing justifiably on diminishing healthcare spending for chronic conditions, rare disease healthcare spending may exceed chronic disease healthcare spending, according to the...
Whether care is affordable for members depends on more than just pricing; affordability is also tied to how clustered healthcare events—and, by extension, healthcare spending—are in a...
Humana announced the launch of a Medicare Advantage (MA) value-based care model for hospice patients, which aims to improve care coordination.
The program comes as part of a four-year...
Challenges to value-based care contract negotiations existed before COVID-19, but the pandemic set the movement back even further. Instead, provider and payer organizations have shifted focus from...
Payers are not leveraging care management to its fullest capacity and they have an opportunity reform their care management programs to improve quality of care and return on investment, a report from...
In its first decade, the Center for Medicare and Medicaid Innovation (CMMI) introduced and honed models to support value-based care, exploring multiple avenues for lowering costs and refining risk...
Payers have started announcing partnerships and investments for 2021 that aim to address social determinants of health, particularly food scarcity, housing insecurity, and health equity.
Some experts...
Medicaid expansion might ensure that homeless individuals receive access not only to healthcare coverage, but also to the care that they need, a Health Affairs study found.
“Our results provide...
Highmark’s value-based care agreement with drug manufacturer Boehringer Ingelheim reduced the overall cost of care for adults with type 2 diabetes, providing more affordable chronic disease...
Payers used artificial intelligence to drive towards key objectives in 2020.
Artificial intelligence is not a new technology, with the first artificial intelligence programs emerging in the early...
Payers that are looking to develop strong healthcare leaders should focus on strengthening learners' care coordination and social determinants of health awareness.
Payers and healthcare...
About four and a half years ago, Chris Carlson, senior vice president of customer experience and complex health solutions at UnitedHealth Group, had a significant conversation with his colleague about...
Payers may consider promoting ambulatory surgery centers as the ideal site of care for joint replacement surgeries, UnitedHealth Group’s recent research findings suggested.
“Findings from...
Value-based care is a perennial goal for the payer industry, but transitioning into risk-based, outcomes-based contracts has proven to be a slow process.
However, Blue Cross and Blue Shield of North...
In recent years, the US has experienced significant improvements in certain preventive care metrics and chronic disease management victories, United Health Foundation found in its America’s...
