New & Notable
House votes to revive enhanced ACA subsidies
The House voted 230-196 to extend the financial assistance, which lapsed on Dec. 31, for three years. The measure is not expected to pass the Senate.
— Healthcare Dive
Anthem sues 11 hospitals over No Surprises Act disputes
Anthem accused Prime Healthcare hospitals of flooding the IDR process with ineligible claims, resulting in $15M more in payments for out-of-network care.
Trump administration ups payer price transparency requirements
The federal government proposed major updates to the Transparency in Coverage rule, including data disclosure changes for in-network rates and more robust consumer-friendly disclosure.
AMA: 97% of U.S. commercial markets highly concentrated in 2024
Limited competition in the health insurer market is driving rising costs and fewer options for patients, the AMA warned in a new study.
Senate rejects competing health bills, setting up ACA subsidy lapse
— Healthcare DiveSponsored Sites
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Interoperability
Veradigm Network to Payer
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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.
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RCM Management
ZOLL Data Systems
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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Employers prioritize cost containment amid rising medical costs: Survey
As medical and pharmacy costs continue to rise, employers are focusing on health benefit cost containment for employees and the organization, a new report shows.
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Payers focus on regulatory compliance ahead of 2026
In addition to regulatory pressure, payers are focused on rising healthcare costs, member engagement and investments in AI heading into the new year.
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Medicare Advantage plans see payments rise with chart reviews
A KFF analysis shows that one in six Medicare Advantage enrollees undergoes a chart review, often leading to additional diagnoses that increase payments to plan sponsors.
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Cigna drops new AI-powered, copay-only health plan
Cigna announces Clearity, a new copay-only health plan that leverages AI tools to engage members and maximize cost savings.
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Epic and Humana launch digital health insurance card checks
Epic's Payer Platform will now store coverage information and digital insurance cards for more than 800,000 Humana Medicare Advantage Members.
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Survey: As Medicaid enrollment remains flat, costs boom
A KFF survey of state Medicaid directors found that most states expect Medicaid enrollment to remain flat in FY 2026, although costs are predicted to increase 7.9%.
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.