New & Notable
Aetna, Cigna, United called out for price transparency failures
A study rates Aetna, Cigna and UnitedHealthcare on compliance with Transparency in Coverage requirements, finding major gaps among all three major U.S. payers.
ACA Marketplace enrollees want coverage, but many to go without
A KFF report shows that 1 in 4 ACA Marketplace enrollees is very likely to go uninsured if monthly premiums double, raising concerns about the expiration of enhanced premium tax credits.
Employers prioritize cost containment amid rising medical costs: Survey
As medical and pharmacy costs continue to rise, employers are focusing on health benefit cost containment for employees and the organization, a new report shows.
Payers focus on regulatory compliance ahead of 2026
In addition to regulatory pressure, payers are focused on rising healthcare costs, member engagement and investments in AI heading into the new year.
CMS proposes overhauling Medicare Advantage star ratings
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Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
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Latest News
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Survey: As Medicaid enrollment remains flat, costs boom
A KFF survey of state Medicaid directors found that most states expect Medicaid enrollment to remain flat in FY 2026, although costs are predicted to increase 7.9%.
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Study: Auto-renewals in Medicaid prevented coverage losses
A new study finds an intervention to facilitate automated Medicaid renewals successful during the unwinding process, signaling a potential solution under Trump's new eligibility rules.
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ACA Marketplaces support care access for kids, parents
With enhanced premium tax credits at risk, families that rely on ACA Marketplace coverage could lose access to healthcare services.
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7 in 10 patients concerned AI will drive unfair claims denials
While patients worry about AI fairness, they recognize the potential the technology has to increase efficiency and potentially access to care.
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Cigna to drop prescription drug rebates for 2027 plan year
The payer said it will instead offer up-front discounts at the pharmacy counter to better reduce costs for patients.
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Do MA Star Ratings incentivize consistent quality performance?
Data shows MA plans move in and out of MA Star Ratings thresholds for lucrative bonus payments, suggesting a potential flaw in the rating system.
Features
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How payers can regain consumer trust via personalized care
Creating personalized health plans is central to regaining consumer trust. To do that, payers must outline safeguards for member data and create seamless experiences.
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With trust low and costs high, do payers stand to lose members?
Healthcare payers might see fewer enrollments as members face higher prices for a product they don't trust or see as high value.
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Breaking down the ABCs of rising alternative health plans
More employers are seeking alternative health plans, like AHPs and ICHRAs, to bend the cost curve, but education is key to navigating their growing popularity.
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What's ahead for prior authorizations as new requirements loom
CMS will require faster decisions and electronic data exchange for prior authorizations; however, providers question whether the requirements will relieve their heavy burden.