New & Notable
AHA urges FTC, DOJ antitrust probe into 340B rebate models
AHA stressed the damage that 340B rebate models would have on hospitals that use 340B savings to treat underserved patient populations.
HHS expands catastrophic coverage eligibility
More people will be able to obtain catastrophic health plan coverage if they qualify for an income-based hardship exemption, HHS announced.
Health plans need human touch to boost member experience
The health plan member experience leaves much to be desired, but more humanized and empathic communication could begin to build trust.
AMA outlines proposed fixes to Medicare Plan Finder
AMA said updating the Medicare Plan Finder tool is a step in the right direction, and urged HHS consider fail-safes to avoid inaccurate data from populating the tool.
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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.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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DOJ Oks UnitedHealth, Amedisys deal on divestiture conditions
DOJ said UnitedHealth and Amedisys could move ahead with the $3.3B acquisition as long as they both divest at least 164 of their home health and hospice facilities.
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Blue Shield of CA adds drug price transparency to member app
Blue Shield of California said the drug price transparency tool will promote a better consumer experience and enable comparison shopping for members.
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Top stats on Medicare Advantage enrollment, costs in 2025
Two new analyses from KFF identify key trends in Medicare Advantage enrollment and costs in 2025, including lower premiums and growth in special needs plans.
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High Part D premium hikes in CMS' crosshairs for 2026 bids
CMS said it has, for the first time, rejected some standalone Medicare Part D standalone plan sponsors because they imposed significant premium increase.
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UnitedHealth faces DOJ investigation after fraud accusations
DOJ has launched an investigation into UnitedHealth Group after several reports that the payer engaged in inappropriate billing in the Medicare Advantage program.
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Humana to reduce prior authorizations for outpatient services
Humana will eliminate a third of prior authorizations for outpatient services by 2026 and publicly report its prior authorization metrics in an effort to increase transparency.
Features
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UnitedHealthcare's provider search tool hinges on consumerism
UnitedHealthcare designed its provider search tool to fulfill the growing demands of healthcare consumerism while nudging the user toward high-value providers.
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Key features of a health insurance member portal
Member portals will be key as health insurance companies adjust to healthcare consumerism and prioritize better member experiences.
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How this payer achieved mental health parity accreditation
Blue Cross Blue Shield of Minnesota says it achieved URAC's mental health parity accreditation because it employs a dedicated team focused on mental health access.
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Exploring Transparency in Coverage schema 2.0, prescription drug prices
Federal agencies unveiled updates to Transparency in Coverage, mandating a new technical schema that promises to improve data and floating prescription drug price transparency.