Healthcare Payers News and Resources for Healthcare

Key Strategies for Exploring Generative AI Use in Health Insurance

October 30, 2023 - Artificial intelligence has been in use in the health insurance industry for decades, but the emergence of generative AI has stirred up new questions around regulation and appropriate use of these technologies in the health insurance space. The new tool faces a number of obstacles to integration. Namely, the lack of regulation and the overabundance of proposed bills or guidelines have...

How Artificial Intelligence, Machine Learning Impact Care Coordination

March 20, 2023 by Kelsey Waddill

When doctors have 2,000 to 3,000 patients on their patient panels, prioritization in care coordination efforts can be challenging. To Stephen Friedhoff, MD, senior vice president of health care...

The Pitfalls, Opportunities of Social Determinants of Health Philanthropy

February 06, 2023 by Kelsey Waddill

Philanthropic efforts can provide a needed boost to disadvantaged communities, but payers that want to offer this kind of support to lessen social determinants of health barriers should be wary of...

Challenges, Opportunities of Digital Health in Health Insurance

January 23, 2023 by Kelsey Waddill

Technology-centered solutions, lack of payer alignment, and competition over data are barriers to digital health advancement in health insurance. Peter Long, executive vice president of strategy and...

Top Healthcare Predictions for 2023: Payer, Provider, Rev Cycle, Life Sciences

January 09, 2023 by Kelsey Waddill

Payers, providers, and life sciences industry leaders will face a variety of pressures in 2023, particularly financially, and they should be alert to their current condition and to opportunities for...

How Employers Can Address Employee Social Determinants of Health

February 14, 2022 by Kelsey Waddill

Employers who leverage demographic data to address social determinants of health needs among their employees are not just doing their employees a favor, they are adopting a strategy that could reduce...

Payers Cover Coronavirus Tests, Physicians Oppose Surprise Billing Act

January 12, 2022 by Hayden Schmidt

This week, CMS announced a new rule requiring commercial insurance groups to cover the cost of coronavirus tests for their members. Insured Americans will now qualify for eight free tests per...

How 3 Policies are Changing the Healthcare Payer Landscape

December 21, 2021 by Hayden Schmidt

In a new report from Insights by Xtelligent Healthcare Media, three recent healthcare rules are examined and their effects on payers are measured. The first of the three regulations examined, the No Surprises Act, aims to protect...

Direct-to-Consumer Telehealth Platforms Lag Behind Competition

November 09, 2021 by Kyle Murphy, PhD

The pandemic has changed patients' use and perceptions of healthcare organizations. The question remains: Will those changes here to stay? Patients Prefer Telehealth Services from Doctors, Health...

Geisinger to Pay $18M for Alleged Medicare Billing Violations

November 05, 2021 by Kyle Murphy, PhD

Hello darkness, my old friend. It's time to turn the clocks back and bid an early goodnight to the sun. Geisinger Settles Allegations for Medicare Billing Violations The US Attorney’s...

Walmart Looks to Expand Its Healthcare Presence to Self-Funded Plans

October 19, 2021 by Kyle Murphy, PhD

The leading retailer continues to make in-roads in the healthcare space, now with an offering aimed at self-funded employer health plans. Walmart Partnership Takes Aim Self-Funded Employer Health...

How Payers Can Overcome Provider Barriers in Value-Based Care

October 11, 2021 by Kelsey Waddill

In 2019, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) made a big change. That year, the company launched its value-based care program Blue Premier in an effort to ensure that every...

Healthcare Consolidation Impacting Market Competition, Consumer Choice

September 30, 2021 by Kyle Murphy, PhD

Healthcare mergers and acquisitions make sense from a business perspective, but they are causing industry stakeholders and federal officials to ask questions about market competition and consumer...

How Payer COVID Waivers Model Value-Based Healthcare Spending

May 03, 2021 by Kelsey Waddill

The healthcare system is currently at a juncture: as the coronavirus pandemic becomes more manageable, will the industry revolutionize its approach to value-based healthcare spending or will it fall...

Add Digital Divide to the List of SDOH; House Bill Might Address Divide with Broadband Access

March 11, 2021 by Sara Heath

Healthcare professionals may be preparing for a post-pandemic world, but they are taking some of the key lessons from COVID-19 with them. Front and center are health equity issues, which have...

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