Healthcare policy and regulation

Policy and regulation significantly affect payers by dictating the standards for health plan offerings, determining coverage requirements, and influencing cost structures. These rules also guide patient data management, ensuring privacy and security, and play a crucial role in shaping overall healthcare market competition, payer strategies and healthcare spending.

Top Stories

News 12 Dec 2025
Senate rejects competing health bills, setting up ACA subsidy lapse

The failure of bills from both Democrats and Republicans means enhanced subsidies for Affordable Care Act plans will likely expire at the end of the year. Continue Reading

— Healthcare Dive
News 10 Dec 2025
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. Continue Reading
By
- Jacqueline LaPointe, Executive Editor

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xtelligent Rev Cycle Management

Financial risk, perseverance pays off for Medicare ACOs
New data show that higher levels of financial risk and time spent in the Medicare Shared Savings Program result in stronger ...
Providers warn of the risk skin substitutes pose to ACOs
Provider groups are worried ACOs will suffer from the recent spike in skin substitute spending, raising concerns about the ...
New value-based payment model aims to boost tech use
A new payment model from the CMS Innovation Center will use fixed, value-based payments to support technology-supported care for ...

xtelligent Virtual Healthcare

FDA pilots allowing digital health devices access to CMS payment program
Companies can ask the FDA to waive premarket authorization and investigational device requirements while they collect real-world ...
5 strategies for selecting, scaling digital health tech
Healthcare leaders shared their most effective strategies for selecting and scaling digital health technology at the 2025 ...
House passes bill extending hospital-at-home waiver for 5 years
The House has passed a bill that would extend the Acute Hospital Care at Home waiver, offering relief to the more than 400 ...

xtelligent Patient Engagement

Are complex guidelines the cause of low cancer screening rates?
Researchers argued that better messaging could clarify complex timing and guidelines for various methods of cervical cancer ...
Zocdoc: Patients valued in-person, timely access to care in 2025
Zocdoc data shows that once patients find the right provider who offers timely access to care, patient loyalty grows.
Do information blocking, test result rules hurt patients?
Immediate resulting provisions under information blocking rules might warrant another look to allow doctors to counsel their ...

xtelligent Health IT and EHR

Texas AG sues Epic over health data, 'monopolizing' EHR industry
In addition to arguments about alleged anticompetitive behavior, the Texas AG is suing Epic Systems for parental access to minors...
Physicians cite ongoing barriers limiting EHR access to outside patient information
A new study shows the majority of physicians still don’t report true interoperable data availability in the EHR.
How Epic, Humana are automating insurance verification
Are we finally doing away with physical insurance cards and manual entry?

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