The "vast majority" of provider-sponsored health plans are unprofitable, Flare Capital Partners Principal Parth Desai pointed out during a recent interview. He said most of these plans aren’t able to cover the large number of lives required to ensure a viable risk pool and maintain a healthy operating margin.
A survey from The Leapfrog Group asked employers to give their health plans an "A" through "F" letter grade. From those letter grades, Leapfrog calculated the health plans’ average Grade Point Average (GPA) on a 4.0 scale. Health plans received a 2.29 GPA in 2022, a slight decrease from Leapfrog’s prior survey in 2020, which had a 2.57 GPA.
This eBook, in collaboration with Care Logistics, details how hospitals and health systems can facilitate more effective decision-making by operationalizing elevated awareness.
About 62% of Americans don’t trust their health plan when it comes to finding care, a Ribbon Health survey found. Providing more accurate information on provider directories could repair this trust.
NovaWell, the behavioral health affiliate of Horizon Healthcare Services, is offering four solutions for health plans and health systems. The program was created from Horizon's own success in New Jersey.
In a survey of Americans with employer-sponsored coverage, 91% of respondents said they’ve experienced a payment-related issue in the past. Another 86% saying they’re worried their health benefits won’t cover all their healthcare needs.
A new report finds most health plans are failing to offer their members seamless digital experiences. Members are frustrated by these oftentimes confusing online journeys, a sentiment that could be costing insurers' revenue and customers.
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Every health plan is required to use real-time benefit tools, which allow physicians to access drug pricing and a patient’s benefit information at the point of care. But, to date, RTBTs haven’t delivered on the promised savings.
Falls are the No. 1 cause of injury and injury-related emergency department visits for adults over 65, costing tens of billions annually. But many healthcare plans are performing poorly in fall prevention.
The company, which offers an AI platform that provides personalized health coaching for chronic disease patients, will use the new funds to invest in research and development and to expand its virtual integrations with health plans and employers.
CMS is lowering the average premium for MA plans to $19 per month in 2022 from about $21 this year. The news comes as several insurers announce new MA plan offerings for 2022, including Humana, which said it will launch 72 plans.
The TSX Venture Exchange has a strong history of helping early-stage health and life sciences companies raise patient capital for research and development.
UnitedHealthcare is planning to participate in the ACA insurance exchanges in Alabama, Florida, Georgia, Illinois, Louisiana, Michigan and Texas. This will bring its total ACA marketplace footprint to 18 states.
A majority of organizations (93%) said they are focused on both attracting and retaining top talent, a new survey from Aon shows. They are offering various benefits to do so, including onsite or near-site health clinics for employees.
CMS will provide $80 million to 60 organizations that train ACA navigators — who help consumers find coverage on the federally funded marketplaces — in the 2022 plan year, up from 30 organizations that received $10 million this year.
Bright Health will use proceeds from its IPO to fund the expansion, which will bring its total number of markets to 141 from 99. The company will also expand its product portfolio in states where it already operates.
The government has intervened in complaints alleging Kaiser Permanente entities defrauded Medicare out of "tens of millions of dollars" by knowingly submitting false diagnoses for Medicare Advantage beneficiaries. Kaiser denies the allegations, saying it is in compliance with program requirements.