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
04 Oct 2024
CMS, HHS update Medicare drug price negotiation process
The next Medicare drug price negotiation cycle might see new parameters around the negotiation platform and more talks around patient experience and pharmacy concerns. Continue Reading
By- Kelsey Waddill, Managing Editor
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Feature
12 Aug 2024
Key MA quality bonus payment program outcomes, concerns
Understanding the quality bonus payment program is critical to appreciating Medicare Advantage and discussing the calls for reform. Continue Reading
By- Kelsey Waddill, Managing Editor
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News
02 Jan 2020
CA Judge: No Proof Dialysis Providers Steer Patients to Payers
The judge stopped a bill that claimed dialysis providers fund third-party payers who steer patients to private insurance, where dialysis costs are higher. Continue Reading
By- Kelsey Waddill, Managing Editor
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News
23 Dec 2019
What is Employer Activism, How Will Payers React to it in 2020?
Employer activism is a trend that has gained traction in the past few years and could shape payers’ 2020 strategies, but it has yet to be well-defined. Continue Reading
By- Kelsey Waddill, Managing Editor
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Answer
03 Oct 2019
Employing Social Workers to Address Social Determinants of Health
Florida Blue is using social workers to help community members in their retail centers address social determinants of health. Continue Reading
By- Emily Sokol, MPH
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News
02 Oct 2019
Alignment Health Plan to Offer Concierge, Social Determinants of Health Benefits
The Southern California-based Medicare Advantage plan, Alignment Health plan, will offer members concierge and social determinants of health benefits in 2020. Continue Reading
By- Emily Sokol, MPH
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kelsey Waddill, Managing Editor
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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
By- Kyle Murphy, PhD, Vice President of Editorial
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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
By- Jessica Kent
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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
By- Jessica Kent
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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
By- Jennifer Bresnick
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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
By- Geneia
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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
By- Jennifer Bresnick
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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
By- Jennifer Bresnick
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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
By- Thomas Beaton
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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
By- Thomas Beaton
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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
By- Vera Gruessner
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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
By- Vera Gruessner
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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
By- Vera Gruessner
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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
By- Vera Gruessner