Blue Shield of California is cutting broker commissions for new enrollments into Medicare Advantage PPO plans in Alameda, Orange and San Diego counties, effective July 1. The new policy does not affect commission payments of existing membership, according to a…
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In June, around 50 insurers pledged their commitment to a set of voluntary actions aimed at simplifying the prior authorization process. The group of insurers, backed by leaders including CMS Administrator Mehmet Oz, MD, said they will work to implement…
A new peer-reviewed study analyzed real-world data from patients of a large, risk-bearing provider, who were also covered by one of New Jersey’s largest health plans. It found that a non-invasive, home-based treatment for knee and back pain reduced musculoskeletal…
An Ohio state judge has temporarily barred a Texas-based insurer that sold health insurance plans to retired law enforcement and fire personnel from operating in the state due to violations of insurance laws. On June 25, a Franklin County judge…
Effective data interoperability in healthcare is no longer an optional enhancement; it’s an essential function for modern medical systems. With its potential to significantly improve operational efficiency and patient outcomes, interoperability ensures seamless communication between diverse healthcare systems. Federal mandates…
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Clear answers to questions are the top driver of members’ experience with their insurers, according to a report from Forrester. The research firm scored insurers on the brand experience index, which measures customers’ and noncustomers’ brand perception, and customer experience…
GuideWell, the parent company of Florida Blue and several health services companies, was ranked on the Fortune 500 for the first time. Guidewell, a not-for-profit mutual holding company, was ranked No. 136 on the list. In a June 25 LinkedIn…
Ahead of the health insurance industry’s broader pledge to overhaul prior authorization processes, one Texas payer has already achieved a 7% prior authorization denial rate, with 100% of those denials upheld upon appeal. On June 23, nearly 50 insurers committed…
Research published in 2025 has highlighted differences in hospital stay lengths and prices paid to hospitals between Medicare Advantage and traditional Medicare. Here are eight studies examining Medicare Advantage Becker’s has reported on in 2025:
Marketplace enrollment could decline between 47% and 57% if premium tax credits expire and proposed changes in Congress become law, according to an analysis from Wakely, a healthcare market research firm . The “One Big Beautiful Bill,” a 1,000+ page…