Medicare, Medicaid and CHIP
Government programs ensure access to healthcare for vulnerable populations. Medicare covers people 65 and older and younger individuals with specific disabilities. Medicaid and the Children's Health Insurance Program (CHIP) are joint federal-state initiatives offering health coverage to low-income families, children, pregnant women, the elderly and people with disabilities.
Top Stories
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News
13 Apr 2026
Payers face faster prior authorization approvals under CMS proposal
Under the proposed rule, affected payers would need to respond to urgent prior authorization requests for drugs within 24 hours and to standard requests within 72 hours. Continue Reading
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News
13 Apr 2026
CMS proposes 2.4% IPPS bump, joint replacement model expansion
A proposed rule would increase inpatient reimbursement by $1.9B next year, while expanding the Comprehensive Care for Joint Replacement Model nationwide. Continue Reading
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News
24 Sep 2019
MA Plans Slowly Begin Integrating SDOH into 2020 Plan Benefits
Medicare Advantage plans and industry experts support CMS’s focus on social determinants of health (SDOH) for new plan benefits but are concerned about its approach. Continue Reading
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News
23 Sep 2019
BSC Creates First-in-State Medicare Supplemental Plan G Extra
The new supplemental Medicare plan will include a fitness program, a telehealth solution, and vision and hearing benefits and replaces Plan F. Continue Reading
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News
15 Aug 2019
Tufts Health Plan and Harvard Pilgrim Announce Merger
Through the merger, the new company will span five states and aims to address affordability, access to care, quality of health, and the patient experience. Continue Reading
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News
26 Jul 2019
Using Virtual Wellness Programs to Drive Member Engagement
Blue Cross Blue Shield of Michigan used an interactive webinar platform to promote whole person well-being in their new, virtual wellness program. Continue Reading
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News
24 Jun 2019
Aetna Partnership Gives Access to At-Home Caregiver Services
Aetna will be offering access to at-home caregiver services through CareLinx to support members as they age at home. Continue Reading
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News
17 Jun 2019
How Major Payers Provide Substance Abuse Care for Opioid Misuse
Aetna, BCBS, and UHC demonstrate three ways to improve substance abuse care for opioid misuse. Continue Reading
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News
29 May 2019
UnitedHealth’s Optum Partners with Talkspace for Behavioral Health
The technology arm of UnitedHealth has signed a strategic partnership with telehealth company Talkspace. Continue Reading
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Answer
05 Apr 2019
What's the Role of Medicare Advantage for Payers and Consumers?
What is Medicare Advantage, and how can payers successfully design these plans to maximize value for beneficiaries? Continue Reading
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News
19 Mar 2019
Amazon Will Accept Health Savings Accounts, Flex Spending on Products
Amazon will now accept funds from health savings accounts and flexible savings accounts when consumers purchase medical supplies. Continue Reading
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News
08 Feb 2019
Lyft Expands Work with BCBS, Humana Medicare Advantage Plans
Lyft is expanding its rideshare partnerships with Medicare Advantage plans from Humana and BCBS. Continue Reading
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News
05 Feb 2019
Reversing Prediabetes with Analytics and Collaboration
Health data analytics can transform chronic disease management and improve outcomes for high-risk patient populations. Continue Reading
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News
23 Jan 2019
86% of Payers Fail to Deliver Readable Medicare Communications
The vast majority of payers are producing Medicare and Medicare Advantage documents that are nearly impossible for most members to understand. Continue Reading
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News
15 Jan 2019
Anthem Medicare Advantage Members Can Use OTC Allowance at CVS
Anthem Medicare Advantage Members in California can now spend their over-the-counter allowance at CVS Pharmacy locations. Continue Reading
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News
19 Oct 2017
Anthem Adds Home Meal Delivery to Medicare Advantage Plans
The payer is providing their Medicare Advantage members with post-discharge home meal delivery service to reduce the likelihood of complications. Continue Reading
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Answer
17 Aug 2017
How Payer Philanthropy Can Address Social Determinants of Health
Payers looking to reduce their downstream spending are pouring millions into addressing the social determinants of health in the community setting. Continue Reading
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News
13 Dec 2016
UnitedHealthcare Cut Costs through Value-Based Care Programs
UnitedHealthcare expanded value-based care programs such as accountable care organizations, which led to reduced spending and a drop in acute inpatient admission rates. Continue Reading
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Answer
02 Sep 2016
How Health Insurance Mergers Could Change the Payer Industry
Potential health insurance mergers have come under such close scrutiny as a result of concerns over how they will change the payer landscape if completed. Continue Reading
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News
19 Aug 2016
Drop Outs in Exchanges, Health Insurance Merger Block Hit Market
The health insurance market has seen significant challenges as many major payers have been dropping out of the health insurance exchanges and the DOJ blocked two health insurance mergers. Continue Reading
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Answer
09 Aug 2016
How Payers Could Succeed in ACA Health Insurance Exchanges
Payers should take advantage of the competition available through the ACA health insurance exchanges in order to succeed. Continue Reading