Payers face numerous challenges when it comes to AI, but that doesn’t mean they shouldn’t use the technology, according to Neil Gomes, senior vice president and chief digital officer of AmeriHealth Caritas.

The post AmeriHealth Caritas Exec: Worst Thing Insurers Can Do Is Be Paralyzed by AI Challenges appeared first on MedCity News.

There is a shortage of GLP-1s in the U.S. But experts have differing opinions on whose responsibility it is to be rationing the drugs.

The post Who Should Be Responsible for Rationing GLP-1s? appeared first on MedCity News.

AHIP, the AMA and NAACOS released a playbook last week that provides the best practices for value-based care. It is based on experiences from physicians, value-based care entities and payers.

The post AHIP, AMA, NAACOS Release Playbook for Value-Based Care appeared first on MedCity News.

America’s Health Insurance Plans, the Better Medicare Alliance and the Association for Community Affiliated Plans all came out against CMS’ final 2025 Medicare Advantage and Part D rate announcement.

The post Insurer Advocacy Orgs Slam Final MA, Part D Rate Announcement appeared first on MedCity News.

One year after the Medicaid continuous enrollment provision ended, 19.2 million people have been disenrolled from Medicaid, according to KFF. This is higher than many expected, and experts have mixed reviews on how they think this process has gone.

The post 1 Year Later: How Has the Unwinding of Medicaid Continuous Enrollment Gone? appeared first on MedCity News.

Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.

The post Healthcare Moves: A Monthly Summary of Hires and Layoffs appeared first on MedCity News.

In submitted comments to the Departments of Health and Human Services, Treasury and Labor, AHIP argued that the proposed mental health parity rule would not expand access to mental health support. It believes the rule should be withdrawn altogether.

The post AHIP: Proposed Mental Health Parity Rule Should Not Be Finalized appeared first on MedCity News.

Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.

The post Healthcare Moves: A Monthly Summary of Hires and Layoffs appeared first on MedCity News.

Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.

The post Healthcare Moves: A Monthly Summary of Hires and Layoffs appeared first on MedCity News.

Amazon has launched and shuttered several healthcare solutions over the years, including Amazon Halo, Amazon Care and Haven. But there have been several lessons learned from these previous solutions, Amazon execs told MedCity News last week at the AHIP 2023 conference in Portland.

The post Amazon Execs: There Are Always Lessons Learned When Trying New Things appeared first on MedCity News.

In order to gain trust from communities, healthcare leaders will need more training on effective communication, said Dr. Vin Gupta, a pulmonologist and chief medical officer of Amazon Pharmacy. He made these comments last week during a panel at the AHIP 2023 conference in Portland.

The post What Are the Challenges in Gaining Trust in Healthcare? appeared first on MedCity News.

There are a lot of administrative hurdles behavioral health providers have to go through to join an insurer’s network. That’s why the industry needs something similar to the “Common App” for applying to be in-network with insurers, said Cara McNulty, president of behavioral health and mental wellbeing at CVS Health. The Common App allows students to apply to multiple colleges through one application.

The post CVS Health Exec: The Behavioral Health Industry Needs a ‘Common App’ for Insurance appeared first on MedCity News.

Health insurers can support the fight for reproductive health rights by improving their benefits and using their power to enact change with lawmakers, said Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America and the Planned Parenthood Action Fund. She made these comments at the AHIP 2023 conference in Portland.

The post How Planned Parenthood’s CEO Wants Insurers To Support Reproductive Health appeared first on MedCity News.

Now that Medicaid redeterminations have resumed, Walgreens is supporting patients by educating them about renewals and helping them navigate through the process, execs said at AHIP 2023 in Portland.

The post How Walgreens Is Supporting Patients During Medicaid Redeterminations appeared first on MedCity News.

Here is a selection of recent executive hires, exits, promotions and layoffs occurring across the healthcare industry.

The post Healthcare Moves: A Monthly Summary of Hires and Layoffs appeared first on MedCity News.

About 68% of Americans believe employer-sponsored insurance is important for employee recruitment and 77% believe it’s important for retention, according to a new AHIP survey. 

The post Survey: 65% of Americans Say Employer-sponsored Insurance Necessary for Financial Security appeared first on MedCity News.

America’s Health Insurance Plans’ new campaign aims to show how health insurers are working to create savings for Americans while also targeting Big Pharma (or more specifically drug manufacturers) for increasing drug costs. The ads will be distributed on TV, social media and streaming services.

The post AHIP Targets Big Pharma in New Campaign appeared first on MedCity News.

The share of traditional Medicare enrollees who bought Medicare Supplement coverage rose to 41% in 2021, compared to 35% in 2017, according to a report from America’s Health Insurance Plans. Medicare Supplement enrollees are three times less likely to have issues paying medical bills than those who only have traditional Medicare.

The post Report: More Traditional Medicare Enrollees Are Buying Medicare Supplement Coverage appeared first on MedCity News.

During a panel at the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum, three executives were asked what gives them comfort about the return to Medicaid redeterminations, as well as what worries them. One CMS official said she’s pleased that states are ramping up communication efforts for Medicaid enrollees, but is concerned about the “insurmountable task” ahead.

The post What Gives 3 Execs Comfort and Concern About Medicaid Redeterminations appeared first on MedCity News.

At the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum held last week, two healthcare leaders from the Centers for Medicare and Medicaid Services (CMS) and CVS Health stressed that reducing maternal health disparities is a top priority, with several strategies at play. For CMS, the focus is on encouraging states to extend Medicaid postpartum coverage, while CVS Health is working to leverage doulas in their care delivery.

The post How CMS, CVS Health Are Tackling Maternal Health Disparities appeared first on MedCity News.

Research shows that about 73% of benefits leaders believe their companies have increased mental health support, but about 40% of employees either don’t believe or are unsure if their company promotes a healthy workplace. When it comes to if there’s a disconnect between employers and employees in mental health, the issue often lies in communication, said Adam Stavisky, senior vice president of US benefits at Walmart.

The post Is There a Mental Health Disconnect Between Employers and Employees? Experts Weigh In appeared first on MedCity News.

Patricia Kelmar, healthcare campaigns director at the Public Interest Research Group, is an advocate for the No Surprises Act. But there’s one thing that bothers her: the fact that providers can ask patients to waive their surprise billing protections, she said Tuesday when speaking at the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum in Washington, D.C.

The post What Keeps One Advocate up at Night About the No Surprises Act appeared first on MedCity News.

CMS put out a request for information in October about a CMS-led national provider directory that would allow patients to find and compare providers based on preferences like language and location. Alexandra Mugge, director and deputy chief health informatics officer of the Health Informatics and Interoperability Group at CMS, said there is stakeholder support for the national directory — if it’s executed correctly.

The post There Is ‘Skepticism and Support’ for National Provider Directory, CMS Official Says appeared first on MedCity News.

Physicians face a lot of barriers from insurers in completing studies on drugs in the accelerated approval pathway, declared Dr. Robert Califf, commissioner of food and drugs at the Food and Drug Administration. Insurers need to help, he said during the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum. 

The post FDA Commissioner: Insurers Need To Support Studies In Accelerated Drug Approval Pathway appeared first on MedCity News.

Improving the mental health workforce shortage is one of the Substance Abuse and Mental Health Services Administration’s top priorities right now, said Miriam Delphin-Rittmon, assistant secretary for mental health and substance use at HHS and the administrator of SAMHSA. To tackle this, the organization has several resources and grant programs in place to recruit more providers and support primary care physicians in treating mental health.

The post How SAMHSA Is Tackling the Mental Health Workforce Shortage appeared first on MedCity News.

During an interview at the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum held Tuesday in Washington, D.C., CMS Administrator Chiquita Brooks-LaSure discussed CMS’ key focus areas for 2023. This includes the end of the public health emergency, health equity and prescription drug costs.

The post CMS Administrator: Telehealth Flexibilities Greatly Expanded Access, But Up To Congress To Extend appeared first on MedCity News.

AHIP and several other healthcare organizations launched the Connecting to Coverage Coalition last week in an effort to make the upcoming Medicaid redetermination process run smoothly. The coalition’s website includes studies on Medicaid redeterminations and frequently asked questions for enrollees. AHIP also released a report that shows 53.6% of those who will lose coverage will transition to employer-sponsored insurance and 21.2% will become uninsured.

The post AHIP-led Coalition Aims To Reduce Coverage Losses Amid Pending Medicaid Redeterminations appeared first on MedCity News.

The final rule calls for stricter audits on Medicare Advantage plans. AHIP president and CEO Matt Eyles referred to the rule as “unlawful and fatally flawed.”

The post Insurers Slam CMS for Medicare Advantage RADV Final Rule appeared first on MedCity News.

An AHIP survey found that 73% of commercially-insured telehealth users think that Congress should make telehealth provisions permanent. These provisions were put in place to meet Americans’ needs during Covid-19.

The post AHIP: Americans Want Congress To Make Telehealth Capabilities Permanent appeared first on MedCity News.

CMS is proposing a system in which it would collect information from providers that would go in a single national directory it maintains. AHIP is seeking a more collaborative directory between the government and private insurers.

The post CMS is proposing a national provider directory. Here’s what AHIP thinks it should look like appeared first on MedCity News.