New & Notable
2.3M young adults could lose Medicaid due to Big Beautiful Bill: study
Actual disenrollment will depend heavily on how easy states make it for young adults, who move frequently and participate in hard-to-track gig work, to prove they should stay enrolled.
— Healthcare Dive
Aetna CTO talks prior auth AI strategy, AI governance
Aetna chief technology officer Nathan Frank says the payer has a product- and business-first approach to AI, steering clear of AI for AI's sake.
62% of young members use AI to choose a health plan
Health plans risk $3 billion in future member lifetime value if they continue to fall short on trust, opening the door for members to build relationships with AI.
Seasonal work risks Medicaid work requirement compliance
One in five adults at risk of noncompliance with Medicaid work requirements already work, with their hours just missing the 20-hour requirement set out by CMS.
Centene taps Fannie Mae executive as CIO
— Healthcare DiveSponsored Sites
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Optum Specialty Fusion
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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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Medicare Advantage member satisfaction lags for second consecutive year
Experts say poor member satisfaction and engagement have damaged overall consumer trust in their Medicare Advantage plans.
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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.
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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.
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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.
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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.
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CMS fraud war room stops $203M in debated Medicaid payments
In less than 90 days, the new Medicaid Fraud War Room blocked payments to 50 unique providers at high-risk of defrauding the federal healthcare program, the CMS says.
Features
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Can Costco hack Medicare Advantage's consumer loyalty problems?
Costco announced it'll sell Medicare Advantage plans in partnership with SCAN Health Plan, testing the wholesaler's consumer loyalty in a new market.
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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.