smorse

Author's posts

Small and medium-sized health plans represent 83 percent of market

Medicare Advantage, managed Medicaid and provider-sponsored plans, represent the bulk of the SMB market.

CMS proposes giving Part D plans greater negotiating power with drug manufacturers.

CMS is proposing to give Medicare Part D drug plans flexibility to negotiate discounts for drugs in "protected" therapeutic classes.

ACA enrollment continues to fall; Insurers have 3 weeks to make gains

This year, 1.92 million people have selected plans, compared to 2.27 million last year when open enrollment began a day earlier.

CVS and Aetna expect to close merger on Wednesday

New York State granted approval Monday contingent upon premium promises, privacy controls, cybersecurity compliance and $40 million towards health insurance education and enrollment.

Humana, Walgreens consider greater partnership

The drug store giant and insurer could expand existing partnership that serves seniors from two Walgreens locations, report says.

Medicaid work requirement in Kentucky gets second approval

After a judge blocked the attempt, CMS opened a new federal public comment period and says it believes KY HEALTH promotes the objectives of Medicaid.

Optum is using AI to predict Alzheimer’s disease

Machine learning makes use of the notes within the EHR, to follow a progression over years.

Use of telehealth in Medicare is limited, CMS says

Only one quarter of one percent of Medicare beneficiaries in 2016 took advantage of the service.

How one hospital prepares for turkey day

Northwell stays vigilant on ER numbers as turkey meat contaminated with salmonella is under a recall.

Artificial Intelligence ROI is coming sooner than you think

With 75 percent of health orgs implementing or planning to execute an AI strategy, OptumIQ said top benefits are improving patient experience and decreasing per-capita care costs.