health insurance
publication date
Payer
Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease but Not a Surprise Bill
A tiny tick bite exposes how prior authorization can apply to inexpensive and medically necessary treatments.
Payer
Contributed Content: Beyond Coverage: How Clinical Strategy and Engagement Are Shaping the Future of Medicare Advantage
The next chapter of Medicare Advantage is being defined by the most forward-thinking plans?those aligning clinical strategy with member engagement...
Innovation
Podcast: A Few Good Things from 2025 (Really)
In the states, there were some wins for healthcare access.
Payer
Shutdown Has Highlighted Washington's Retreat from Big Ideas on Healthcare
As health costs reach a crisis point, a yawning gulf exists between voters' desire for more aggressive action and the...
Payer
As Health Companies Get Bigger, So Do the Bills. It's Unclear if Trump's Team Will Intervene.
Even well-insured patients receive unaffordable bills in this era of high-deductible health plans, narrow insurance networks, and 20% cost sharing.
Payer
Congressional Stalemate Creates Chaos for Obamacare Shoppers
The fate of the enhanced premium tax credits remains up in the air, with the prospect of significantly higher premiums...
Payer
A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal
Most insurers submitted two sets of premium rates to states this year in case Congress agreed to extend the subsidies.
Payer
GOP Talking Point Holds ACA Is Haunted by 'Phantom' Enrollees, but the Devil's in the Data
The percentage of enrollments without any medical claims was 19% in 2021. That percentage jumped to 35% in 2024. Critics...
Payer
A New Car vs. Health Insurance? Average Family Job-Based Coverage Hits $27K
Premiums for job-based health insurance rose 6% in 2025 to an average of $26,993 a year for family coverage.
CFO
AI vs. Red Tape: How Automation Is Saving Medicaid Margins
As Medicaid cuts loom and administrative costs soar, CFOs are turning to AI to protect margins, streamline operations, and expand...
Payer
Why Democrats Are Casting the Gov't. Shutdown as a Healthcare Showdown
Democrats see the high-stakes standoff as a chance to talk about affordable health care as millions of Americans.
Payer
Big Loopholes in Hospital Charity Care Programs Mean Patients Still Get Stuck With the Tab
Even if people qualify for financial help with their hospital bills, the care they receive may not be covered.