New & Notable
Key MA quality bonus payment program outcomes, concerns
Understanding the quality bonus payment program is critical to appreciating Medicare Advantage and discussing the calls for reform.
Members rarely challenge coverage denials, surprise billing
Only 45% of individuals who received a surprise bill challenged it and only 43% of those who were denied coverage appealed the decision.
What are the differences between Medicare Parts A, B, C, D?
Medicare includes four different segments that each insure a wide variety of services and supplies for enrollees.
Data, technology strategies boost payer patient education
Analytics platforms, omnichannel engagement tools, telehealth, and other technological and data advancements have been pivotal to successful payer patient education.
Insights
Insights is the research division of Xtelligent Healthcare Media. 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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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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Medicare Part D Patients with HIV May See Lower Drug Costs Under IRA
Medicare Part D beneficiaries with HIV will benefit from the out-of-pocket healthcare spending cap and the expansion of low-income subsidy coverage.
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OIG Strengthens Oversight Strategy for Managed Care Organizations
The four-phase managed care life cycle reinforces OIG’s goals of ensuring access to care, providing financial oversight, and promoting data accuracy.
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HHS Attributes Record Low Uninsurance Rate to ACA Enrollment
The US uninsured rate dropped to 7.7 percent in 2023 after Affordable Care Act marketplace enrollment soared to 16 million enrollees.
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Payers, Employers Support the No Surprises Act IDR Process in Court
While providers disapprove of basing out-of-network payment rates on the qualifying payment amount, payers and employers have defended the No Surprises Act policy.
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Generic Insulin Drug Pricing, Access Still Pose Problems for Uninsured
While some progress has been made, drug pricing, availability, and confusion among consumers prevent uninsured Americans from gaining easy access to insulin.
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HHS Proposed Rule Aims to Distinguish STLDI from Comprehensive Plans
Short-term, limited-duration insurance (STLDI) plans are too difficult for consumers to differentiate from traditional plans which can lead to underinsurance, HHS stated.
Features
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How the Affordable Care Act Impacted the Individual Market
The passing of the Affordable Care Act in 2012 shook up the individual health insurance marketplace and eight years later, the market is still feeling its impact.