New & Notable
Employers eye ICHRAs, but affordability remains a concern
More than one-third of employers offering health benefits are at least evaluating an ICHRA, although marketplace instability and costs are hindering adoption.
80% of adults unfamiliar with Medicaid work requirements
Medicaid work requirements are set to begin in January, putting pressure on states to educate members about the program requirements to prevent loss of coverage.
Black, Hispanic patients underrepresented in value-based care models
White, high-income patients living in urban areas are more likely to benefit from value-based care models, limiting the generalizability of model results.
State-based subsidies saved some ACA Marketplace losses
States that offered their own subsidies to consumers had lower ACA Marketplace enrollment losses, according to new KFF data.
CMS moves to codify limits on Medicaid provider taxes
— Healthcare DiveSponsored Sites
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Specialty Drug Management
Optum Specialty Fusion
At Optum, we’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. Together, for better health.
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
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Revenue Cycle Management
Greenway Health
Improving healthcare through innovation is at the heart of Greenway Health’s work. We provide electronic health records (EHR), practice management, and revenue cycle management solutions that help practices in multiple specialties grow profitably, remain compliant, work more efficiently, and improve patient outcomes.
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.
View All Episodes
Latest News
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Health plans fall short in maternity care member communication
Health plans and their members have different ideas of what constitutes good member communication during pregnancy, a new report shows.
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ACA premiums set to surge 14% as tax credits expire
Payers offering ACA Marketplace plans proposed another double-digit premium increase, driven by rising healthcare costs, labor shortages and the lapse of enhanced premium tax credits.
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Study: Bariatric surgery beats GLP-1s on long-term costs, outcomes
Bariatric surgery costs $109 less per month than GLP-1 drugs for obesity and diabetes patients, with faster weight loss and better outcomes over 12 years, study finds.
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3.8M qualify for Medicare GLP-1 Bridge at program's July start
With 3.8M Medicare enrollees qualifying for the GLP-1 Bridge, the program could lay the groundwork for future payment models for the weight loss drugs.
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HHS cut 3M ACA Marketplace enrollments in ongoing fraud efforts
The agency said it rooted out fraudulent Affordable Care Act enrollments following the 2025 Trump rule that laid out stricter eligibility, enrollment and enforcement standards.
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ACA Marketplace premiums might see a double-digit spike in 2027
The early look at ACA Marketplace premiums shows that the tax credit lapse and rising medical cost trend could lead to high premium costs for consumers in 2027.
Features
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Inside Elevance's digital chronic disease management strategy
The payer uses multiple chronic disease management programs to avoid a one-size-fits-all approach to member engagement.
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5 healthcare pros on the trends defining primary care
The 2025 Payer + Provider Virtual Summit explored AI, value-based care and community-based partnerships, offering strategies on how to promote primary and preventive care.
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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.