New & Notable
7 in 10 patients concerned AI will drive unfair claims denials
While patients worry about AI fairness, they recognize the potential the technology has to increase efficiency and potentially access to care.
Cigna to drop prescription drug rebates for 2027 plan year
The payer said it will instead offer up-front discounts at the pharmacy counter to better reduce costs for patients.
Do MA Star Ratings incentivize consistent quality performance?
Data shows MA plans move in and out of MA Star Ratings thresholds for lucrative bonus payments, suggesting a potential flaw in the rating system.
CMS calls back furloughed employees to help with Medicare, ACA enrollment periods
Roughly 3,000 employees are coming back to work on Monday, funded by user fees as the shutdown drags into its fourth week.
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Huron
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Financial Responsibility
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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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With no subsidies, ACA Marketplace premiums to double
Should enhanced premium subsidies lapse in 2026, the typical Affordable Care Act marketplace enrollee can expect to pay more than double for their premiums.
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Study: Children rely on Medicaid, but many face coverage gaps
The majority of U.S. children enroll in Medicaid or CHIP during childhood, but many won't stay covered for 18 years, indicating worsening coverage gaps under the Big Beautiful Bill.
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Health status of those affected by Medicaid work requirements
Those most likely to lose coverage under Medicaid work requirements balance multiple chronic illnesses and prescription drugs, study data shows.
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Nearly all Medicare Part D plans require prior auth for GLP-1s
A new study finds rising prior authorization requirements and out-of-pocket costs for GLP-1RAs covered by Medicare Part D plans.
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Which SDOH do seniors want health plan benefits to address?
Aging in place, access to healthcare and economic insecurity are leading SDOH affecting senior health and wellbeing.
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4.8M lose coverage with expired enhanced premium tax credits
Allowing Marketplace enhanced premium tax credits would affect health insurance affordability for millions.
Features
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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.
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Breaking down the ABCs of rising alternative health plans
More employers are seeking alternative health plans, like AHPs and ICHRAs, to bend the cost curve, but education is key to navigating their growing popularity.
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What's ahead for prior authorizations as new requirements loom
CMS will require faster decisions and electronic data exchange for prior authorizations; however, providers question whether the requirements will relieve their heavy burden.
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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.