Accountable care organizations have been around in Medicare for more than a decade, generating more than $22 billion in savings and giving back more than $8 billion to the Medicare Trust Fund. But a handful of ACOs has consistently been at the top of the list of top savers, including…
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Latest news being reported on payers and the health insurance industry including news from Cedar, Independence Blue Cross, CVS Health, UnitedHealth Group, Oscar Health, Vivante Health, and more.
By Eric Demers – In 2022, 20% of adults said they or their family received an unexpected medical bill. The No Surprises Act, which went into effect last year, is better late than never. A bipartisan effort to protect patients from unexpected healthcare expenses, the NSA minimizes surprise billing and makes…
By Mo Weitnauer – Healthcare quality reporting is evolving, and accountable care organizations are at the forefront of this change. In 2025, ACOs will be required to shift from traditional quality reporting via the CMS Web Interface to eCQMs, marking a significant transition in their reporting process.
By Peter Bresler – Health systems are pursuing digital initiatives to meet their unprecedented financial and strategic challenges. These initiatives include the creation of a modern consumer-grade experience, automating myriad back office processes, and delivering care using virtual technologies.
By Anup Panthaloor – As states disenroll millions of individuals from their Medicaid rolls, small and medium sized health plans with managed Medicaid plans face multiple risks. Their Medicaid members are losing access to care, many of them erroneously, with 72% of members being disenrolled for procedural reasons.
Latest news being reported on payers and the health insurance industry including news from Sendero Health Plans, CVS Health, RxBenefits, IBX, UnitedHealthcare, Humana, Lumeris, Aetna, CVS Health, Blue Cross Blue Shield Association, UnitedHealth Group, and more.
By Matt Fisher – Without taking time to think about an answer, what first comes to mind when asked where the cost for healthcare services is the highest? In or connected to a hospital is the usual answer. Is that the correct answer? It can be complicated (as everything in healthcare usually is), but there are more than a few grains of truth and accuracy to the answer.
Latest news being reported on payers and the health insurance industry including news from CVS Health, American Medical Association, UnitedHealthcare, Independence Blue Cross, Humana, CareSource, Blue Cross Blue Shield, Cigna, and more.