New & Notable
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.
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.
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.
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.
Sponsored Sites
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Cybersecurity
Commvault + Microsoft
Together, Commvault and Microsoft are redefining cybersecurity and data resilience with a comprehensive, integrated platform, purpose-built to secure, defend, and recover data wherever it lives with true cloud simplicity, intelligence, and scale.
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Specialty Drug Management
Optum Specialty Fusion
At Optum, we’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. Together, for better health.
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
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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AHA urges FTC, DOJ antitrust probe into 340B rebate models
AHA stressed the damage that 340B rebate models would have on hospitals that use 340B savings to treat underserved patient populations.
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HHS expands catastrophic coverage eligibility
More people will be able to obtain catastrophic health plan coverage if they qualify for an income-based hardship exemption, HHS announced.
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Health plans need human touch to boost member experience
The health plan member experience leaves much to be desired, but more humanized and empathic communication could begin to build trust.
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AMA outlines proposed fixes to Medicare Plan Finder
AMA said updating the Medicare Plan Finder tool is a step in the right direction, and urged HHS consider fail-safes to avoid inaccurate data from populating the tool.
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States to receive immigration reports on Medicaid enrollees
The Trump Administration is doubling down on honing Medicaid enrollment, with CMS now alerting states about Medicaid enrollees with unverified citizenship or immigration status.
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Medicare Advantage member satisfaction declines as trust wanes
A lack of trust and increased confusion amid policy shifts have contributed to a decline in Medicare Advantage member satisfaction, new J.D. Power data shows.
Features
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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.
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Key features of a health insurance member portal
Member portals will be key as health insurance companies adjust to healthcare consumerism and prioritize better member experiences.
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How this payer achieved mental health parity accreditation
Blue Cross Blue Shield of Minnesota says it achieved URAC's mental health parity accreditation because it employs a dedicated team focused on mental health access.