Making Prior Authorization Easier
Learn how insurance companies can streamline the process with AI, automatic approvals, and better communication to improve patient care.
Medicare and Medicaid Updates for 2026
On December 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule introducing significant policy and technical changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (PACE) for Contract Year 2026.
Healthcare 2025
With the election of a new president who is signaling significant interest in overhauling healthcare policies, the stakes are high for providers, payers, and policymakers. What lessons can be drawn from the past, and what predictions can we make about the road ahead?
Payer Views: Innovating Healthcare through Comprehensive Health Plans
Explore how comprehensive health plans drive innovation, improve outcomes, and reduce healthcare costs.
Demystifying Medicare Advantage Plans
Medicare Advantage plans are a popular alternative to Original Medicare for many seniors who want more coverage and flexibility. But what exactly are Medicare Advantage plans and how do they work?
Medicare Advantage Growth Aggravate Prior Authorization Burdens
Medicare Advantage growth aggravates prior authorization burdens in several ways. Most medical groups, providing care to patients with Medicare Advantage plans, must comply with more prior authorization requirements.
Health Plan Headaches Need Long-term Solutions
Health plan headaches begin with several challenges while navigating the rapidly evolving healthcare landscape. These challenges are driven by a combination of factors, including rising healthcare costs, regulatory changes, technological advancements, and shifting consumer expectations.
Medicaid Growth in 2022/23 and the Impact on Underserved Populations
Medicaid growth has been driven by several factors, including changes in federal policy, public pressure, and a greater understanding of the benefits of Medicaid for underserved populations.
Medicaid Solutions for Addressing Behavioral Health
Children 16 years old and younger and young adults between 17 and 24 years who are leaving a public system of care such as foster care or a residential behavioral health facility are at increased risk of becoming homeless.
States Passing Record Number of Laws Controlling Drug Pricing
A record number of laws have been passed by states this year to increase affordability and access to prescription drugs, according to Kaiser Health News.