-
20% of ACA marketplace enrollees are new to program: HHS
About 4.6 million people have signed up for health insurance through ACA marketplaces as of Nov. 18. -
Blues plans dive into care delivery
As the nation's largest insurers have evolved to become health services organizations capable of providing healthcare and paying for it too, several Blue Cross Blue Shield companies are following suit and becoming providers as well. -
Moody's: Payers' 2023 outlook is stable
Insurers' outlook is stable for 2023, but high Medicare Advantage utilization rates could present challenges, Moody's said in a Nov. 20 report. -
Medicaid in the headlines: 7 recent updates
New research found the number of self-pay patients increased as enrollees lost Medicaid coverage, and Georgia lawmakers are mulling a full expansion of the state's Medicaid program. -
CMS cut Medicaid improper payments in 2023
The Medicaid improper payment rate significantly decreased from 2022 to 2023, CMS reported Nov. 15. -
Medicare solvency would be extended 17 years under Medicare Advantage utilization rates: Study
The Hospital Insurance Trust Fund would be solvent until 2048 if traditional Medicare utilization levels were similar to those under Medicare Advantage, according to research published in October by AHIP and conducted by Avalere. -
Insurers aren't following CMS' new Medicare Advantage rules, AHA says
Some Medicare Advantage plans are not planning to comply with new CMS guidance requiring plans to follow traditional Medicare's standards for coverage decisions, the American Hospital Association alleges. -
CMS: Medicare Advantage received $16.6B in improper payments in 2023
CMS paid Medicare Advantage organizations an estimated $16.6 billion in overpayments in fiscal year 2023, the agency reported Nov. 15. -
More employers consider narrow networks, low deductibles
Four in 10 employers offer low or no-deductible plans, and 15% of employers will offer their employees coverage with no premium, according to Mercer's "Health and Benefit Strategies for 2024" report. -
6 payers expanding ACA offerings in 2024
From UnitedHealth expanding plans to 26 states total to Centene expanding its footprint within 11 markets, these are six payers expanding their exchange offerings in 2024. -
25 states with 'failing' Medicaid redetermination grades
Half of states are "failing" amid the Medicaid redeterminations process, according to the NAACP. -
3 payer CEOs among healthcare's 'most overpaid'
Three payer CEOs are among As You Sow's list of the most "overpaid" CEOs at S&P 500 companies. -
Excellus BCBS awards $28M to 31 hospitals
Excellus BlueCross BlueShield awarded 31 upstate New York hospitals and health centers a combined $28 million in 2022 for quality care improvements. -
HHS' call to action for payers on health equity
CMS issued its first-ever playbook to address social determinants of health Nov. 16. -
Georgia mulls Medicaid expansion
Georgia Republican lawmakers heard testimony on possible Medicaid expansion for the first time in a decade, The Atlanta Journal-Constitution reported Nov. 17. -
Demand for no-premium Medicare Advantage plans hits plateau: Report
Fewer Medicare Advantage beneficiaries are choosing no-premium plans for 2024, according to eHealth's November snapshot report that tracks MA and Part D plans selected by beneficiaries in the first half of the current annual enrollment period, or Oct. 15 to Nov. 8. -
Medicare Advantage in the headlines: 9 recent updates
UnitedHealthcare is facing a lawsuit of alleged wrongful Medicare Advantage care denials, and lawmakers are eyeing new regulations on the program. -
Value-based care members get more preventive screenings: Humana
Patients in value-based care relationships were more likely to receive preventive screenings than those in fee-for-service only, according to Humana's 10th annual value based care report. -
Why Medicare Advantage networks may reduce avoidable hospitalizations
Differences in the clinicians Medicare Advantage and traditional Medicare beneficiaries see have some effect on differences in avoidable hospitalization rates between the two programs, a study published Nov. 10 in JAMA Health Forum found. -
5 payers named among top military-friendly employers
Five payers have been named to the 21st annual list of Military Friendly Employers, which measures an organization's commitment, effort and success in creating sustainable and meaningful benefits for the military community.
Page 1 of 50