SCAN Health Plan will start a “Brokers as Health Navigators” program across its Arizona, Nevada, New Mexico, Texas and Washington markets, according to a Feb. 23 news release. “Many of the best brokers are already acting as trusted advisors, guiding…
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In February, CMS released a final report on its Accountable Health Communities model, which launched in 2017 and ran until 2023. The model focused on addressing “upstream drivers of health,” or social determinants, for Medicaid and original Medicare beneficiaries. These…
One question was at the root of Aetna Better Health of Illinois’ recent partnership with Elektra Health, a virtual menopause care platform: “Where are we seeing healthcare needs popping up that don’t have a solution?” During an episode of the…
Oakland, Calif.-based Kaiser Permanente is suing nine liability insurers for breach of contract, alleging they have refused to cover any portion of its $556 million settlement with the federal government resolving False Claims Act allegations tied to Medicare Advantage billing…
CMS outlined next steps for its Medicare Advantage provider directory and shared plans to “beta launch” a broader National Provider Directory later this year, according to a Feb. 18 document. The agency has structured the initiative in three phases. The…
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Connecticut enrolled a record 157,246 residents in marketplace plans for 2026, a 4% increase over last year, even as national ACA enrollment fell by more than 1 million people. The state’s marketplace, Access Health CT, announced the results Feb. 19.…
Humana’s board of directors declared a $0.885 per share dividend to be paid April 24. The dividend will be paid to all shareholders of record as of the close of business March 27, according to a Feb. 19 Humana news…
Medicare Advantage now covers about 55% of eligible beneficiaries nationwide — more than 35 million people — but health systems are confronting a question that until recently felt almost taboo: What happens when participation in the country’s fastest-growing Medicare program…
Recently, payers and providers have been engaging in a slew of transparency campaigns, with some aiming to “expose” pricing and denial concerns. For example, Hospital Watch has come to the forefront, shifting blame to hospitals. “Hospital Watch is a watchdog…
Optum has launched Value Connect, an AI-powered platform designed to help payers and providers operationalize value-based care models by combining clinical, operational and financial data into a single system. The platform uses AI across quality measures, utilization patterns and risk…