Payer

Medicare Advantage enrollment has reached nearly 31.2 million, according to a February report from CMS.

If an individual is accused of defrauding Tennessee's Medicaid program, or TennCare, the state will post the name and photo of that individual for anyone to view online, or even place that individual on a public 'most wanted' list across…

Editor's note: On March 23, Chartis published a revised version of its Medicare Advantage enrollment report. The new report, based on updated data from CMS, showed that Medicare Advantage growth did not slow in 2022 compared to previous years. Medicare…

CVS Health tops the list of largest payers in Medicare Part D membership. 

As the number of Americans enrolled in high-deductible health plans continues to grow, recent studies conducted by researchers at some of the nation's top hospitals and medical schools have linked HDHPs with worse health outcomes, less spending on preventive care,…

Payers are adding new solutions for home health, diabetes and specialty drugs. 

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.