New & Notable
What does member experience mean for health payers?
A better member experience is key for health payers working to improve consumer loyalty and support their financial bottom lines.
U.S. healthcare spending soars on diabetes, heart diseases
Cardiovascular diseases were the costliest conditions, while U.S. healthcare spending on type 2 diabetes beat out other single conditions, according to a new study.
Unpacking claim denials in light of public backlash against payers
Claim denials fuel public frustration with U.S. healthcare; high denial rates, AI use and payer policies spark calls for change, including more transparency in medical billing.
Top cybersecurity strategies for healthcare payers
Healthcare payers can conduct internal risk assessments, train employees and stay informed about upcoming regulations to bolster cybersecurity efforts.
Insights
Insights is research conducted by and for TechTarget Xtelligent Healthcare. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Cybersecurity
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Social Determinants of Health
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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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Downside risk in healthcare improves MA outcomes
Medicare Advantage with downside risk improves care, cutting hospital visits, high-risk medication use and enhancing efficiency compared to fee-for-service MA.
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HealthCare.gov's 2023 in-network claim denial rate hit 1 in 5
High in-network claim denial rates continue to be a key source of plan member dissatisfaction.
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CMS releases final ACA marketplace payment notice for 2026
The 2026 updates to the ACA marketplace include calculation updates for risk adjustment, slight changes to cost-sharing reduction loading practices and more.
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2025 ACA open enrollment breaks records with time to spare
This ACA open enrollment season saw 3.2 million new enrollees enter the marketplace and those numbers could grow before the season ends on Jan. 15, 2025.
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How to overcome weaknesses in Medicaid postpartum coverage
Medicaid postpartum coverage extensions have been critical, but states face challenges addressing access to care, quality of care and MCO accountability.
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High health costs force small employers to up cost-sharing
As small businesses struggle to keep up with rising healthcare costs, many have increased cost-sharing for their workers in both single and family coverage.
Features
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Weighing employer GLP-1 coverage considerations
Employer GLP-1 coverage decisions will be swayed by potential ROI and current company financial resources.
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2025 Medicare, Medicaid trends to watch in spending, strategy
The new year brings many old challenges, such as high spending trends, but payers in Medicare and Medicaid will weather these difficulties through insightfulness and agility.
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5 pillars that underpin payer population health strategies
The healthcare system faces many challenges, but by focusing on these five pillars, payers can establish holistic and effective population health strategies.
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Understanding Medicare vs. Medicaid vs. CHIP
Medicare, Medicaid and CHIP are very influential in the healthcare industry at large, often steering trends in value-based care, social determinants of health and health equity.