Payer

If you work in the Talent or HR department at your organization, you know how important benefits plan design is for retaining and attracting talent. A recent survey found that employees who are satisfied with their benefits are 1.8x more…

A report from the Office of the New York State Comptroller published Jan. 6 found Anthem Blue Cross either did not recover or remit over $19.3 million in hospital claim overpayments and relied on incorrect time periods to evaluate the…

Wisconsin’s Medicaid program is projecting a $213.2 million shortfall through fiscal year 2027, driven largely by higher-than-expected enrollment in long-term managed care programs, according to a Jan. 5 report from the state Department of Health Services. The projected deficit, which…

Premera Blue Cross is expanding its case management resources for cancer care, according to a Jan. 6 news release. The patient navigation program, called Premera Cancer Support, relies on a partnership with Thyme Care, an oncology startup that focuses on…

The expiration of enhanced ACA premium tax credits and new Trump administration policies mean big changes for catastrophic and bronze ACA plans in 2026, per KFF.  Six notes:

President Donald Trump said Jan. 6 that he plans to meet with 14 insurance companies “in a few days” to pressure them to lower prices for Americans. “We’re trying to solve the healthcare problem. We’re trying to get better healthcare…

Youth mental health has been a pressing issue in recent years. With Medicaid as the country’s largest payer for mental health services, the program’s role is all the more essential. The National Academy for State Health Policy evaluated state Medicaid…

A joint fund created to stabilize health insurance costs for New York City employees and retirees is insolvent and has accrued $3.1 billion in unreported liabilities, according to a Dec. 30 audit from the NYC Comptroller. The audit found that…

Clever Care Health Plan CEO Karen Walker Johnson, BSN, thinks her company’s edge is one that bigger insurers might have trouble replicating. That edge is Clever Care’s focus on offering “culturally sensitive Medicare options,” and it is baked into the…

New York Gov. Kathy Hochul blamed a 38% average spike in health insurance premiums for state residents on the Dec. 31 expiration of ACA enhanced premium tax credits. The average monthly increase for a New York couple is $228. Out…