Payer

The ACO Realizing Equity, Access, and Community Health model is the latest shared-savings model designed by CMS to improve care and reduce costs in traditional Medicare. 

The following list ranks the states by the percentage of their private-sector employees who were enrolled in high-deductible health insurance plans in 2021. The U.S. national average is 55.7 percent.

CMS issued a proposed rule Dec. 6 that it says will streamline the prior authorization process. Here are four major changes the rule would bring that would affect payers, according to a Feb. 21 report from the Kaiser Family Foundation:

There's a worldwide shortage of diabetes management drug Ozempic, and health plans may be playing a key role, BuzzFeed News reported Jan. 13.

From its CEO becoming the first woman elected to chair the Business Council, to the payer being named among the nation's best large employers, here are eight updates about Elevance Health Becker's has reported since Jan. 31:

Here are three states seeking or implementing work requirements for their Medicaid programs:

Payers are challenging contract decisions and noncompete agreements in court. 

The number of adults in a Medicaid-enrolled family that are unaware of impending redeterminations remains high across the nation.

A group of 70 lawmakers is pressing CMS on further Medicare Advantage reforms, and the agency is considering implementing prior authorization reforms and other changes to the program. 

The Indiana Department of Insurance tapped data management and analytics firm Onpoint Health to administer the state's All Payer Claims Database.