New & Notable
Medicaid work requirements might spur 5M in coverage losses
Experts say complex documentation requirements might cause those meeting Medicaid work requirement criteria to lose their coverage.
KLAS: Top data analytics platforms for payers
Payer organizations are increasingly relying on data analytics platforms to drive better member outcomes.
Reimagining value-based care to unlock quality care
After years of slow progress, employers and other purchasers need to approach value-based care differently, considering network design, price transparency and direct contracting.
CMS ends federal funding for state Medicaid DSHPs, DSIPs
CMS indicated that DHSPs and DSIPs go beyond the scope of Medicaid services and therefore do not warrant federal funding.
Insights
Insights is research conducted by and for TechTarget Xtelligent Healthcare. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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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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CMS releases CY 2026 Medicare Advantage payment policies
The CY 2026 Rate Announcement included higher-than-expected Medicare Advantage payments to plans next year and continued the phase-in of risk adjustment model changes.
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CMS: Medicare Part D will not cover GLP-1s for weight loss
CMS did not provide many details about its decision to reverse proposed Medicare Part D coverage for GLP-1s for weight loss.
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ACA Marketplace enrollment hits record-high 24.3M enrollees
ACA Marketplace enrollment soared in 2024 in large part due to enhanced subsidies making premiums less costly for consumers.
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Average monthly Medicare Part D premiums jump 24%
Medicare Part D premiums and deductibles rose significantly during a particularly disruptive annual enrollment period, eHealth found.
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Medicaid cuts could spark $95B in state GDPs in 2026
Medicaid cuts could result in hundreds of thousands fewer healthcare jobs and billions in state and local tax revenue.
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Optum RX targets cuts to prior authorization for some meds
The move to scrap reauthorization for 80 prescription drugs will ultimately eliminate 10% of prior authorization requirements.
Features
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How employers can promote preventive healthcare for members
Employers should examine their benefits, including those they don’t use, to assess how they can promote preventive healthcare access among employees.
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How companies find solutions to employer GLP-1 coverage
Employer GLP-1 coverage has serious cost barriers, but some companies are turning to technology vendors to provide a comprehensive approach to access.
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Employers seek healthcare price transparency to control costs
Navigate rising costs by leveraging healthcare price transparency, direct provider contracts and data access, despite ongoing challenges for employers.
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What does member experience mean for health payers?
A better member experience is key for health payers working to improve consumer loyalty and support their financial bottom lines.