New & Notable
Medicaid improper payments increase, reaching $37.39B
Medicaid, CHIP and Medicare Advantage all saw increases in improper payment rates in FY 2025, while Medicare fee-for-service's rate remained below 10%.
Medicare Advantage overpayments will total $76B this year: MedPAC
The federal government will pay an estimated $76 billion more to cover Medicare Advantage seniors this year than it would if those same seniors were in traditional Medicare, according to new estimates from an influential advisory group.
— Healthcare Dive
Trump unveils healthcare affordability plan
The "Great Healthcare Plan" is vague, but would send money directly to ACA enrollees and entrench Trump’s drug pricing deals.
— Healthcare Dive
2026 ACA enrollment lags by 1.5M signups amid subsidy fight
ACA marketplace enrollment decreased for the first time since 2020, potentially due to lapsed premium subsidies.
House votes to revive enhanced ACA subsidies
— Healthcare DiveSponsored Sites
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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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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.
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Healthcare
Huron
Change is constant in healthcare, and its speed is accelerating. Huron works with healthcare organizations every day to strengthen and innovate their businesses and build more resilient operations to thrive now and in the future.
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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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.
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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.
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Tips for employers weighing GLP-1 coverage, health IT vendors
Employers should assess health IT vendors that can tailor GLP-1 coverage pathways, provide lifestyle support and guide users discontinue use.
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Employer-sponsored insurance costs outpaced inflation in 2024
Experts state that spikes in employer-sponsored insurance premiums will strain employees' pocketbooks again this year.
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Aetna, Cigna, United called out for price transparency failures
A study rates Aetna, Cigna and UnitedHealthcare on compliance with Transparency in Coverage requirements, finding major gaps among all three major U.S. payers.
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ACA Marketplace enrollees want coverage, but many to go without
A KFF report shows that 1 in 4 ACA Marketplace enrollees is very likely to go uninsured if monthly premiums double, raising concerns about the expiration of enhanced premium tax credits.
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.