A Medicare tool for adjusting risk underpredicts mortality and overpredicts spending for rural beneficiaries, according to research from the Philadelphia-based Leonard Davis Institute of Health Economics at the University of Pennsylvania. The study, published in the September 2025 issue of…
Research & Analysis
Nearly 70% of Medicaid enrollees diagnosed with an opioid use disorder did not receive appropriate medications — such as buprenorphine, methadone or naltrexone — within 180 days of diagnosis, according to a study published Nov. 23 in The American Journal…
Insurers carry out chart reviews to verify alignment between medical records and information submitted by providers. While these reviews can help payers understand a beneficiary’s needs and increase payments to accommodate anticipated costs, they could also be used inappropriately. “Chart…
Over 90% of Medicare Advantage beneficiaries believe that supplemental benefits can improve health and save money, according to a Nov. 20 Humana Healthcare Research survey. Humana’s research organization, coupled with input from the University of Pennsylvania, surveyed 5,979 of the…
Employers can expect a 6.7% increase in total health benefit costs in 2026 — the steepest in 15 years — according to the 2025 National Survey of Employer-Sponsored Health Plans from consulting firm Mercer. The cost per employee is slated…
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A recent study from St. Louis-based Washington University assessed administrative burdens that low-wage individuals face with Medicaid and SNAP. While issues with SNAP were generally more prevalent, Medicaid had unique challenges. Here are five takeaways on Medicaid burdens: 1. The…
A Nov. 10 study found risk-based Medicare Advantage contracts had little effect on healthcare delivery. The University of Pennsylvania’s Leonard Davis Institute of Health Economics reviewed Medicare Advantage insurer data to better understand the ramifications of moving from fee-for-service to…
Use of a grocery card benefit by Medicare Advantage dual-eligible enrollees correlated to increased office visits, according to an October study from the Elevance Health Public Policy Institute. “If you’re not as concerned about procuring food … you have more…
Eighty-eight percent of Americans are content with their health coverage, yet nearly half rate the country’s overall system a “C” or worse, according to a Nov. 6 survey from health insurance marketplace eHealth. The survey collected input from 1,524 adults…
Health plans found that 39% of provider’s surprise billing disputes were ineligible for arbitration and never should have been submitted to the federal independent dispute resolution process, according to a survey published Oct. 24. The No Surprises Act established the…