Value-Based Care News

BCBSA Outlines Next Steps for Health Equity Data Standardization

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Blue Cross and Blue Shield Association (BCBSA) and the Blue Cross and Blue Shield companies have urged the healthcare industry to adopt national health equity data collection standards. The companies...

Low Socioeconomic Status Negatively Impacted Healthcare Delivery

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Medicare beneficiaries in low socioeconomic status (SES) areas had higher rates of avoidable hospital admissions and emergency department visits but lower instances of physician and care management...

Humana Outlines Social Determinants of Health Industry Progress

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Payers, providers, and policymakers have taken a variety of approaches to social determinants of health data collection and interventions, according to an issue brief from Humana. The brief provided...

BCBSRI Joins Global Capitation Model, Starts 2022 RI Life Index

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Blue Cross & Blue Shield of Rhode Island (BCBSRI) has entered into a global capitation agreement in its Medicare Advantage program, according to a press release which HealthPayerIntelligence...

Top Employer Strategies for Health Equity in Obesity, Diabetes

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When it comes to obesity and diabetes benefit design, employers can—and should—adopt a health equity mindset, according to a flipbook from the Northeast Business Group on Health...

4 ACA Marketplaces Take Action to Advance Health Equity

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California, Connecticut, the District of Columbia, and Massachusetts pursued different Affordable Care Act marketplace strategies in order to improve health equity for underserved populations,...

7 Challenges, Costs of Utilization Management for Employers

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Certain utilization management techniques—such as step therapy and prior authorization—may increase employees’ costs and restrict access to care, especially for employees with chronic...

Uninsured Adults Less Likely to Access Mental Healthcare Services

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Uninsured adults with moderate to severe symptoms of anxiety or depression were less likely to receive mental healthcare services compared to adults with healthcare coverage, according to a Kaiser...

CQMC Finds Quality Measurement Gaps, Supports Digital Measures

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Members of the Core Quality Measures Collaborative (CQMC), including AHIP, have identified multiple quality measurement gaps and recommended new digital quality measures and health equity quality...

Value-Based Care Models That Could Lower Maternal Care Costs

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Maternal healthcare costs in the US are too expensive, but value-based care may provide a solution, according to a brief from AHIP. “Americans need and deserve safe, high-quality, equitable and...

Privately Insured Catheter Users Incurred High Out-of-Pocket Costs

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Catheter users who received health insurance coverage from private health plans incurred higher annual out-of-pocket costs compared to catheter users on a government or public health plan, according to...

Out-of-Pocket Healthcare Spending Higher for Pregnant People

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Pregnant people were more likely to experience high out-of-pocket healthcare spending, but Medicaid and public health insurance coverage helped minimize costs compared to private insurance, a study...

Obstacles to Covering Precision Medicine Multicancer Screenings

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While precision medicine multicancer screening tests could blaze a path to lower cancer-related costs and earlier cancer detection, these precision medicine tools face many hurdles to acquiring payer...

Consumers Emphasize Insurer Role in High Healthcare Spending

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Most Americans reported that health insurers are not successfully deflecting high healthcare spending and many survey respondents sought more transparency and out-of-pocket healthcare spending support...

Uninsurance Rate Among Black Americans Dropped 8% Under ACA

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The Affordable Care Act may have led to reduced the uninsurance rate among Black Americans since it went into effect, according to a report from the Assistant Secretary for Planning and...

National Healthcare Spending, Prices Saw Modest Increase in 2021

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National healthcare spending increased by 3.4 percent in 2021, while the Health Care Price Index (HCPI) maintained a year-over-year growth of around 2 percent, according to Altarum’s February...

AHIP: Next Steps Toward Primary, Behavioral Healthcare Integration

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AHIP called on providers and policymakers to join payers in their efforts to integrate behavioral healthcare and physical healthcare in an issue brief on the subject. The payer organization laid out...

Top 10 Most Expensive Chronic Diseases for Healthcare Payers

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Chronic diseases are on the rise in the United States, leaving healthcare payers with the challenge of covering care for patients with these expensive, long-term conditions. Chronic diseases are such...

30% of Seniors Still Experience Impacts of Foregone, Delayed Care

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Senior members might continue to see canceled or delayed care even as coronavirus cases decline, a trend which has had significant impacts on payer revenues and spending in 2020 and 2021, a report from...

Low Value Care Spending on Low Back Pain Is Decreasing

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The healthcare industry is making strides in diminishing low value care spending for commercially-insured patients with chronic low back pain (LBP), according to a research letter published in JAMA...