Category: Health Insurance

California Nursing Home Residents Told To Find New Homes

Dozens of frail nursing home residents have been informed by their Medi-Cal managed care plans that they are no longer eligible for long-term care. Some health care advocates and legal aid attorneys fear that such terminations will increase as the state implements mandatory managed care for nursing home residents.

Financial incentives plus information decrease patient preference for potentially wasteful diagnostic testing

Discussing benefits and risks of low-value diagnostic testing via head CT scan with patients can reduce the prevalence of such testing.

Self-funded employers are playing an increasing role in taking on the status quo to lower costs

The insurance industry will remain but the traditional PPO is beginning to come to an end as costs are outstripping inflation and wages, CEO says.

Reducing wasteful spending in healthcare by curbing administrative complexity

Wasteful spending is an increasingly thorny problem in healthcare, especially with the industry comprising an ever-larger portion of GDP.

Employers Are Scaling Back Their Dependence On High-Deductible Health Plans

Firms are offering more traditional plans alongside or instead of the plans with sky-high deductibles that may have been the only option in the past. The change comes as employers are finding that workers like the predictability of a traditional plan and that providing more generous plans can help with recruiting in a tight labor market.

Employers Are Scaling Back Their Dependence On High-Deductible Health Plans

Firms are offering more traditional plans alongside or instead of the plans with sky-high deductibles that may have been the only option in the past. The change comes as employers are finding that workers like the predictability of a traditional plan and that providing more generous plans can help with recruiting in a tight labor market.

Kaiser, Oscar, Blue Cross Blue Shield plans among big winners of cost sharing reduction payments

In total, Affordable Care Act insurers in class action lawsuit will receive over $1.5 billion in damages from 2017 and 2018.

Operational efficiencies saved hospitals from further earnings decline

Mergers and acquisitions helped grow revenue but it’s taking health systems longer to realize expected synergies.

States Try A Gentler Approach To Getting Medicaid Enrollees To Work

Facing GOP pressure to install work requirements for adults getting Medicaid coverage, some states seek instead to offer more opportunities for job training.

Study finds racial bias in Optum algorithm

Optum calls the study’s conclusions “misleading” as health systems use many data elements other than cost to select patients for clinical engagement.