New & Notable
Most people benefit from the ACA's free preventive services
A new report shows that a majority of privately insured patients used at least one preventive service covered by the ACA, saving thousands on out-of-pocket costs.
How are states preparing for Medicaid work requirements?
A recent KFF report outlined the variable strategies states have adopted to implement Medicaid work requirements, ranging from enforcement to IT adoption.
Cigna exits ACA exchanges despite dramatic profit growth in Q1
The Connecticut-based insurer plans to say goodbye to the ACA exchanges after this year, and is exploring a potential sale of its controversial claims review subsidiary.
— Healthcare Dive
Payers promise standardized electronic prior auths
After announcing an 11% reduction in prior authorizations, major payers are now focusing on standardizing an electronic request process.
Sponsored Sites
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Financial Responsibility
CareCredit
We do something very simple at CareCredit: We help people get the care they want for themselves and their families.
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Revenue Cycle Management
Greenway Health
Improving healthcare through innovation is at the heart of Greenway Health’s work. We provide electronic health records (EHR), practice management, and revenue cycle management solutions that help practices in multiple specialties grow profitably, remain compliant, work more efficiently, and improve patient outcomes.
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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.
View All Episodes
Latest News
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Digital member experience improves for health plans, gaps remain
A recent JD Power survey showed that, although the digital member experience is improving for health plans, there's room to grow for onboarding and patient education.
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Major payers say they cut prior authorizations by 11%
Major Blues plans, Cigna, Humana and United are among the payers reporting reduced prior authorizations amid an industry-wide push to streamline the process.
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Insurers get a 2.48% MA pay bump after close call with a flat rate
CMS backtracked on a less than 1% payment rate increase for Medicare Advantage plans, instead finalizing a nearly 2.5% boost and sidestepping risk adjustment changes.
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CMMI has lost $5.4B. Now, lawmakers are questioning its value.
A new GAO report found a 5% success rate for models tested by the CMS Innovation Center, prompting lawmakers to consider reform to advance value-based care.
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After ACA subsidy lapse, consumers opt for low-cost Marketplace plans
The number of patients selecting low-cost, high-deductible ACA marketplace plans rose from 30% to 40% for the 2026 Open Enrollment Period.
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UnitedHealthcare launches AI chatbot for member care navigation
UnitedHealthcare said the AI chatbot will support customer advocates by handling simple care navigation tasks and referring members to advocates when needed.
Features
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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.
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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.