Commercially insured patients pay substantially different rates for the same procedure, with negotiated costs for inpatient procedures varying by an average ratio of 9.1, according to an August report from market intelligence firm Trilliant Health. The report reviewed health plan…
Author: Elizabeth Casolo
An estimated 3 out of 5 U.S. children have been enrolled in Medicaid or the Children’’s Health Insurance Program, according to a Harvard T.H. Chan School of Public Health model. As of 2024, states must provide a year of continuous…
Brewer, Maine-based Northern Light Health President and CEO Timothy Dentry voiced frustration with Anthem Blue Cross and Blue Shield in a Sept. 26 letter as the contract end date between the two organizations looms. “It is disappointing and deeply concerning…
On Sept. 25, Georgia Gov. Brian Kemp shared how CMS extended the state’s Pathways to Coverage program through 2026, despite a recent finding from the U.S. Government Accountability Office that the Medicaid work requirement program had spent over twice as…
CMS removed its enrollment sanction on eternalHealth on Sept. 10, according to a news release from the agency. In March, CMS suspended enrollment for eternalHealth’s Medicare Advantage-Prescription Drug Plan contracts after Massachusetts requested the insurer to cease marketing its products…
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Counterpart Health, a subsidiary of Clover Health, is leaning more on generative AI to scale value-based care, allowing clinicians to interact with patient data through a chat function, according to a Sept. 25 news release. Counterpart Assistant, an AI-powered physician-enablement…
Twenty-one health insurance companies made the inaugural list of “America’s Best Employers For Company Culture” by Forbes and Statista, a Hamburg, Germany-based data analytics firm, published Sept. 18. Forbes and Statista heard from over 218,000 workers at companies with at…
Insurers have until Sept. 30 to issue ACA Medical Loss Ratio rebates for 2024. The Medical Loss Ratio mandates insurance companies spend at least 80% or 85% of their premium dollars on medical care, not administrative expenses or profits. If…
PacificSource will no longer serve 100,000 Medicaid members in Lane County — which includes Eugene, Ore. — after failing to reach an agreement with the Oregon Health Authority, PacificSource Vice President of Medicaid Programs Erin Fair Taylor told Becker’s. “We…
Aging in place, medical care access and economic insecurity are the top three social factors that affect aging experience, according to Alignment Health’s “2025 Social Threats to Aging Well in America Survey.” Over 2,200 adults age 65 or older completed…