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HealthPayerIntel @hpayerintel

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

Joined August 2015
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369 Photos and videos
Some states have already cut in-person interviews and limited renewals to once a year, aligning with Medicaid and CHIP final rule policies. - bit.ly/4asGsfN
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Payers should implement vendor management programs, incident response plans, and training processes to prepare for third-party security incidents. - bit.ly/4cwdAVc

How can payers be prepared to manage third-party security incidents...

Payers should implement vendor management programs, incident response plans, and training processes to prepare for third-party security incidents.

techtarget.com
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Payers can use the next couple of years to establish a solid technology strategy to ensure compliance with the prior authorization final rule. bit.ly/3OIAoqN

Overcoming Tech Barriers to Achieve Prior Authorization Transparenc...

Payers can use the next couple of years to establish a solid technology strategy to ensure compliance with the prior authorization final rule.

techtarget.com
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Health systems do not invest in the infrastructure needed to support Medicare Advantage, while health plans offer low reimbursement, leading to contract terminations. bit.ly/3w8pWCr
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In addition to an increase in Medicare Advantage plan payments, CMS proposed updates to the Part D risk adjustment model and star ratings. bit.ly/3OuFczJ

CMS Proposes 3.7% Increase in Medicare Advantage Plan Payments | Te...

Medicare Advantage plan payments will increase by 3.7 percent or $16 billion in 2025, CMS proposed.

techtarget.com
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In 2024, payers must comply with Medicare Advantage marketing requirements, price transparency regulations, and prior authorization policies. bit.ly/3TG3cDj
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Healthcare coverage for the LGBTQ population differs depending on a member’s state, health plan, and service needed. bit.ly/3SoCiPW
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Data-sharing, value-based contracts, and standardized quality measures are critical to improving payer-provider alignment. bit.ly/3QyF6J0
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Per its settlement, Cigna must conduct annual risk assessments, but all Medicare Advantage plans should be proactively monitoring their compliance actions. bit.ly/48YmhpA

What Cigna’s FCA Settlement Means for Other Medicare Advantage Plan...

Per its settlement, Cigna must conduct annual risk assessments, but all Medicare Advantage plans should be proactively monitoring their compliance actions.

techtarget.com
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Around 42 percent of Medicare Advantage plans received 2024 star ratings of four or higher, down from 51 percent in 2023. bit.ly/3M4VM8i
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[New Article] API marketplaces are pivotal for enhancing innovation by streamlining operations, improving #memberexperiences, and strengthening #provider relationships. Sponsored by @ZelisHealthcare bit.ly/3PXhoWr
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[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 bit.ly/3ES7AGT
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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. bit.ly/3rnJTTG

The Medicare Advantage Marketing Problem and Where It’s Headed | Te...

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.

techtarget.com
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[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 bit.ly/3sYRzw6
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[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 bit.ly/3sFwZR9
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The Blue Cross Blue Shield Association boasts 34 independent companies that provide healthcare coverage to people across the United States. bit.ly/489IQXW
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Following through on the Inflation Reduction Act provisions, the Biden-Harris Administration will begin Medicare price negotiations with the drug companies this fall. bit.ly/3KYPgz6

HHS Releases First 10 Drugs Eligible for Medicare Price Negotiation...

HHS has announced the first ten drugs that will be available for Medicare price negotiation starting in 2026.

techtarget.com
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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. bit.ly/45JC2yr
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To reduce emergency department admission rates, payers can implement virtual care, machine learning, and value-based care strategies. - bit.ly/47n28ZB

How Payers Can Reduce Emergency Department Admission Rates, Costs |...

Emergency department use can be reduced by implementing value-based care, machine learning, telehealth, virtual care, and other strategies.

techtarget.com
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The projected decrease in Medicare Part D premiums reflects premium stabilization and improved Part D benefits, both tied to the Inflation Reduction Act. - bit.ly/3YkzP9Z
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