HealthPayerIntel

An online publisher featuring latest news and exclusive interviews in the health payer industry. Part of Xtelligent Healthcare Media. @xtelligenthc

[HealthPayerIntel @hpayerintel]

Some states have already cut in-person interviews and limited renewals to once a year, aligning with Medicaid and CHIP final rule policies. - https://t.co/aStGfn8uG5

[HealthPayerIntel @hpayerintel]

Payers should implement vendor management programs, incident response plans, and training processes to prepare for third-party security incidents. - https://t.co/BxpWWLTNqw

[HealthPayerIntel @hpayerintel]

Payers can use the next couple of years to establish a solid technology strategy to ensure compliance with the prior authorization final rule. https://t.co/oZvdjOvFN5

[HealthPayerIntel @hpayerintel]

Health systems do not invest in the infrastructure needed to support Medicare Advantage, while health plans offer low reimbursement, leading to contract terminations. https://t.co/wBQzNSUJYU

[HealthPayerIntel @hpayerintel]

In addition to an increase in Medicare Advantage plan payments, CMS proposed updates to the Part D risk adjustment model and star ratings. https://t.co/iQ8faiNTGn

[HealthPayerIntel @hpayerintel]

In 2024, payers must comply with Medicare Advantage marketing requirements, price transparency regulations, and prior authorization policies. https://t.co/OTMPSUO6L5

[HealthPayerIntel @hpayerintel]

Healthcare coverage for the LGBTQ+ population differs depending on a member’s state, health plan, and service needed. https://t.co/hwJAqEG1hp

[HealthPayerIntel @hpayerintel]

Data-sharing, value-based contracts, and standardized quality measures are critical to improving payer-provider alignment. https://t.co/ZLyn4zPusU

[HealthPayerIntel @hpayerintel]

Per its settlement, Cigna must conduct annual risk assessments, but all Medicare Advantage plans should be proactively monitoring their compliance actions. https://t.co/DJDJ4kb3i3

[HealthPayerIntel @hpayerintel]

Around 42 percent of Medicare Advantage plans received 2024 star ratings of four or higher, down from 51 percent in 2023. https://t.co/OzvadwUcij

[HealthPayerIntel @hpayerintel]

[New Article] API marketplaces are pivotal for enhancing innovation by streamlining operations, improving #memberexperiences, and strengthening #provider relationships. Sponsored by @ZelisHealthcare https://t.co/ho9hra0LN8

[HealthPayerIntel @hpayerintel]

[New Article] #APIs are reshaping healthcare by improving member and provider interactions, driving digital maturity in health plans, and offering real-time information access, cost #transparency, and streamlined processes. Sponsored by @ZelisHealthcare https://t.co/kXvuk27f51

[HealthPayerIntel @hpayerintel]

With new Medicare Advantage marketing regulations in place for 2024, payers must work with their marketing teams and establish proactive oversight programs to ensure compliance. https://t.co/Tu1XtAZEzQ

[HealthPayerIntel @hpayerintel]

[New Article] Healthcare payers are harnessing the power of #APIs to create seamless member experiences, streamline operations, and stay competitive in the digital #healthcare landscape. Sponsored by @ZelisHealthcare https://t.co/VC4CNXjV3P

[HealthPayerIntel @hpayerintel]

[New Article] #Payers need a proven framework for #paymentintegrity to create financial value, handle change, and engage at the highest levels of organizational strategy. Sponsored by @ClarisHealthUS https://t.co/rhhu5CHZKl

[HealthPayerIntel @hpayerintel]

The Blue Cross Blue Shield Association boasts 34 independent companies that provide healthcare coverage to people across the United States. https://t.co/BNDahaw15T

[HealthPayerIntel @hpayerintel]

Following through on the Inflation Reduction Act provisions, the Biden-Harris Administration will begin Medicare price negotiations with the drug companies this fall. https://t.co/MyIRmynRc9

[HealthPayerIntel @hpayerintel]

Mental health issues were the most commonly cited impact of COVID-19 and mental health initiatives were the highest priority for employers looking toward 2024. https://t.co/22PEZiwRWi

[HealthPayerIntel @hpayerintel]

To reduce emergency department admission rates, payers can implement virtual care, machine learning, and value-based care strategies. - https://t.co/qgoGxiP4VZ

[HealthPayerIntel @hpayerintel]

The projected decrease in Medicare Part D premiums reflects premium stabilization and improved Part D benefits, both tied to the Inflation Reduction Act. - https://t.co/6IJLzLqm17