As prior authorizations have come under the regulatory and legislative microscope, several payers have announced cuts to their requirements.
The Latest
AHIP has named its general counsel, Julie Simon Miller, to serve as interim CEO, effective Oct. 2.
Aledade, a network of independent primary care providers, and Florida Blue's ACO has resulted in millions in shared savings for participating providers and improved health outcomes for 41,000 members in the program's first two years.
Highmark's value-based reimbursement program for primary care physicians, True Performance, has saved more than $3 billion in avoided cost savings in Pennsylvania, Delaware and West Virginia since its launch in 2017.
Medicare Advantage enrollment is growing faster in rural and micropolitan areas than in metropolitan areas, according to an analysis from KFF published Sept. 7.
Employers that self-fund their employees' insurance pay moderately more for several medical services than fully funded plans, a study published in the September issue of Health Affairs found.
Humana filed a challenge to CMS' Medicare Advantage clawback rule and said it plans to expand into in-home primary care.
ACA exchange enrollment reached a record high in early 2023, and the individual market reached an almost record size, according to an analysis from KFF published Sept. 7.
Most growth in Medicare Advantage enrollment since 2006 was driven by people switching from fee-for-service Medicare to the program, a study by HHS researchers published in the September issue of Health Affairs found.
Blue Cross Blue Shield of Michigan is the latest payer to announce it is scaling back its prior authorization requirements.