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 06 Dec 2024
Lawmakers promote access to direct primary care in Medicaid

While Medicaid programs can use waivers to implement direct primary care, a law that is under consideration in the Senate would make it easier for states to take this approach. Continue Reading
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
News 26 Nov 2024
CMS suggests public payer weight loss drug coverage changes

Amid suggestions around prior authorizations and AI use, CMS introduces a policy that would expand weight loss drug coverage in Medicare Advantage, Medicaid and Part D plans. Continue Reading
By
- Kelsey Waddill, Managing Editor and Multimedia Manager

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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Emily Sokol, MPH
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Emily Sokol, MPH
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
By
- Emily Sokol, MPH
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
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
By
- Kyle Murphy, PhD, Vice President of Editorial
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
By
- Jessica Kent
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
By
- Jessica Kent
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
By
- Jennifer Bresnick
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
By
- Geneia
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
By
- Jennifer Bresnick
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
By
- Jennifer Bresnick
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
By
- Thomas Beaton
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
By
- Thomas Beaton
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
By
- Vera Gruessner
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
By
- Vera Gruessner
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
By
- Vera Gruessner
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
By
- Vera Gruessner

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