Medicare, Medicaid and CHIP
Government programs ensure access to healthcare for vulnerable populations. Medicare covers people 65 and older and younger individuals with specific disabilities. Medicaid and the Children's Health Insurance Program (CHIP) are joint federal-state initiatives offering health coverage to low-income families, children, pregnant women, the elderly and people with disabilities.
Top Stories
-
News
11 Apr 2025
CMS ends federal funding for state Medicaid DSHPs, DSIPs
CMS indicated that DHSPs and DSIPs go beyond the scope of Medicaid services and therefore do not warrant federal funding. Continue Reading
-
News
08 Apr 2025
CMS releases CY 2026 Medicare Advantage payment policies
The CY 2026 Rate Announcement included higher-than-expected Medicare Advantage payments to plans next year and continued the phase-in of risk adjustment model changes. Continue Reading
-
News
11 Feb 2020
Humana Primary Care Clinics Boost Senior Patient Care Access
The payer-agnostic primary care centers will expand access to care by opening primary care centers for seniors on Medicare Advantage. Continue Reading
-
News
11 Feb 2020
How Provider Relationships Shape VBC Pediatric Quality Measures
By building a robust payer-provider relationship, payers can better ascertain the right quality measures to mobilize pediatric quality measures in value-based care. Continue Reading
-
News
10 Feb 2020
Cigna Starts 3 Strategic Partnerships While Closing 2019 M&A Deals
Major payers like Cigna are overlapping finalizing of previous mergers and acquisitions deals with new partnership announcements that aim to strengthen payer identity. Continue Reading
-
News
28 Jan 2020
Centene-WellCare Merger Alters GA Medicaid Managed Care Landscape
The health insurance merger places Centene-WellCare in charge of two-thirds of Georgia’s Medicaid HMO business and significantly impacts the Medicaid managed care landscape. Continue Reading
-
News
28 Jan 2020
BCBS Tackles Outpatient Generic Medication Spending, Access
BCBS Association and Blue Cross Blue Shield companies are focusing on increasing access to care through lowering outpatient generic medication spending. Continue Reading
-
Answer
27 Jan 2020
Virtual Behavioral Health Visits Improve Care Access
Cigna’s partnership with MDLIVE gives members the ability to schedule and attend virtual behavioral health appointments, improving adherence and access to care. Continue Reading
-
News
22 Jan 2020
Louisiana’s Medicaid Managed Care Contracts in Disarray
Louisiana’s Medicaid care contracts have been scrapped due to the claims that the health department mishandled the bid process for deals to provide health services to 1.5 million people. Continue Reading
-
News
22 Jan 2020
Blue Shield of CA Pledges $20M to Support Behavioral Health Services
The contribution will support behavioral health services and initiatives to tackle the homelessness crisis in order to ensure that commitment to health and wellness is at the forefront. Continue Reading
-
News
21 Jan 2020
Medicare Advantage Costs 40% Less than Fee-For-Service Medicare
Medicare Advantage tends to cost less in both premiums and out-of-pocket costs than fee-for-service Medicare, the report found. Continue Reading
-
News
17 Jan 2020
AL Providers, Payer Form Value-Based Medicare Advantage Plan
In a new trend, Huntsville Hospital and UAB are joining together to offer their own health plan, a value-based Medicare Advantage plan through Viva Health. Continue Reading
-
News
15 Jan 2020
Cigna, Oscar Health Form New Brand for Small Business Plans
The Cigna + Oscar brand will sell small business plans that aim for affordability and integration with telehealth solutions. Continue Reading
-
News
13 Jan 2020
How Payer Value-Based Contracts Seek to Cut Gene Therapy Costs
CVS Health recommends value-based contracting, coordinated care, and other strategies to lower gene therapy costs. Continue Reading
-
News
13 Jan 2020
Community Data Informs Payer Philanthropy for Housing Stability
Addressing housing stability is the first step towards healthy living. BCBSRI is tackling this social determinant of health from all angles after the results of the RI Life Index. Continue Reading
-
News
06 Jan 2020
Using Individualism and Company Culture to Boost Employee Health
PwC suggests improving employee health by letting individuals design their health goals and using company culture, not as an end goal, but rather to serve those goals. Continue Reading
-
News
03 Jan 2020
Opposite Opinions on Cost of Care End Payer-Provider Contracts
UnitedHealthcare and Cigna end contracts with large health systems due to differences of opinion on reimbursement, healthcare spending, and cost of care. Continue Reading
-
News
02 Jan 2020
CA Judge: No Proof Dialysis Providers Steer Patients to Payers
The judge stopped a bill that claimed dialysis providers fund third-party payers who steer patients to private insurance, where dialysis costs are higher. Continue Reading
-
News
23 Dec 2019
What is Employer Activism, How Will Payers React to it in 2020?
Employer activism is a trend that has gained traction in the past few years and could shape payers’ 2020 strategies, but it has yet to be well-defined. Continue Reading
-
Answer
03 Oct 2019
Employing Social Workers to Address Social Determinants of Health
Florida Blue is using social workers to help community members in their retail centers address social determinants of health. Continue Reading
-
News
02 Oct 2019
Alignment Health Plan to Offer Concierge, Social Determinants of Health Benefits
The Southern California-based Medicare Advantage plan, Alignment Health plan, will offer members concierge and social determinants of health benefits in 2020. Continue Reading
-
News
24 Sep 2019
MA Plans Slowly Begin Integrating SDOH into 2020 Plan Benefits
Medicare Advantage plans and industry experts support CMS’s focus on social determinants of health (SDOH) for new plan benefits but are concerned about its approach. Continue Reading
-
News
23 Sep 2019
BSC Creates First-in-State Medicare Supplemental Plan G Extra
The new supplemental Medicare plan will include a fitness program, a telehealth solution, and vision and hearing benefits and replaces Plan F. Continue Reading
-
News
15 Aug 2019
Tufts Health Plan and Harvard Pilgrim Announce Merger
Through the merger, the new company will span five states and aims to address affordability, access to care, quality of health, and the patient experience. Continue Reading
-
News
26 Jul 2019
Using Virtual Wellness Programs to Drive Member Engagement
Blue Cross Blue Shield of Michigan used an interactive webinar platform to promote whole person well-being in their new, virtual wellness program. Continue Reading
-
News
24 Jun 2019
Aetna Partnership Gives Access to At-Home Caregiver Services
Aetna will be offering access to at-home caregiver services through CareLinx to support members as they age at home. Continue Reading
-
News
17 Jun 2019
How Major Payers Provide Substance Abuse Care for Opioid Misuse
Aetna, BCBS, and UHC demonstrate three ways to improve substance abuse care for opioid misuse. Continue Reading
-
News
29 May 2019
UnitedHealth’s Optum Partners with Talkspace for Behavioral Health
The technology arm of UnitedHealth has signed a strategic partnership with telehealth company Talkspace. Continue Reading
-
Answer
05 Apr 2019
What's the Role of Medicare Advantage for Payers and Consumers?
What is Medicare Advantage, and how can payers successfully design these plans to maximize value for beneficiaries? Continue Reading
-
News
19 Mar 2019
Amazon Will Accept Health Savings Accounts, Flex Spending on Products
Amazon will now accept funds from health savings accounts and flexible savings accounts when consumers purchase medical supplies. Continue Reading
-
News
08 Feb 2019
Lyft Expands Work with BCBS, Humana Medicare Advantage Plans
Lyft is expanding its rideshare partnerships with Medicare Advantage plans from Humana and BCBS. Continue Reading
-
News
05 Feb 2019
Reversing Prediabetes with Analytics and Collaboration
Health data analytics can transform chronic disease management and improve outcomes for high-risk patient populations. Continue Reading
-
News
23 Jan 2019
86% of Payers Fail to Deliver Readable Medicare Communications
The vast majority of payers are producing Medicare and Medicare Advantage documents that are nearly impossible for most members to understand. Continue Reading
-
News
15 Jan 2019
Anthem Medicare Advantage Members Can Use OTC Allowance at CVS
Anthem Medicare Advantage Members in California can now spend their over-the-counter allowance at CVS Pharmacy locations. Continue Reading
-
News
19 Oct 2017
Anthem Adds Home Meal Delivery to Medicare Advantage Plans
The payer is providing their Medicare Advantage members with post-discharge home meal delivery service to reduce the likelihood of complications. Continue Reading
-
Answer
17 Aug 2017
How Payer Philanthropy Can Address Social Determinants of Health
Payers looking to reduce their downstream spending are pouring millions into addressing the social determinants of health in the community setting. Continue Reading
-
News
13 Dec 2016
UnitedHealthcare Cut Costs through Value-Based Care Programs
UnitedHealthcare expanded value-based care programs such as accountable care organizations, which led to reduced spending and a drop in acute inpatient admission rates. Continue Reading
-
Answer
02 Sep 2016
How Health Insurance Mergers Could Change the Payer Industry
Potential health insurance mergers have come under such close scrutiny as a result of concerns over how they will change the payer landscape if completed. Continue Reading
-
News
19 Aug 2016
Drop Outs in Exchanges, Health Insurance Merger Block Hit Market
The health insurance market has seen significant challenges as many major payers have been dropping out of the health insurance exchanges and the DOJ blocked two health insurance mergers. Continue Reading
-
Answer
09 Aug 2016
How Payers Could Succeed in ACA Health Insurance Exchanges
Payers should take advantage of the competition available through the ACA health insurance exchanges in order to succeed. Continue Reading