New & Notable
Employer strategies to address factors driving healthcare costs
High healthcare costs have motivated employers to think creatively about their benefits and strategies, from rethinking their partnerships with PBMs to finding ways to limit GLP-1 utilization.
How enhanced premium tax credits could affect health equity
If the Inflation Reduction Act's enhanced premium tax cuts are renewed in 2025, they could increase enrollment among populations with higher uninsurance rates.
Key MA quality bonus payment program outcomes, concerns
Understanding the quality bonus payment program is critical to appreciating Medicare Advantage and discussing the calls for reform.
Members rarely challenge coverage denials, surprise billing
Only 45% of individuals who received a surprise bill challenged it and only 43% of those who were denied coverage appealed the decision.
Insights
Insights is the research division of Xtelligent Healthcare Media. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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CMS shares Medicaid, CHIP data on children with ASD, autism
CMS found that half of the children with these conditions in public payer programs were diagnosed early, which could positively impact outcomes.
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Medicare Advantage, individual markets did well financially in 2023
As plans continue to recover from the pandemic, Medicare Advantage plans continued their strong performance, financially, in 2023.
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5 Ways to Modernize the Healthcare Payments Experience
Modernizing the healthcare payments experience can improve efficiency, compliance and satisfaction among health plans, providers, and members.
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Improving LTPAC Management Interventions Using Real-Time Analytics
Real-time analytics improves care management in long-term care by enabling timely interventions and enhancing outcomes under value-based care models.
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3 Tips to Reduce Provider Abrasion and Enhance Payment Integrity
Enhancing payment integrity and reducing provider abrasion require clear communication, human expertise in complex billing, and customized solutions to ensure effective relationships between providers and payers.
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How Inaccurate Provider Data from Payers Impacts Access to Care
When payers’ online provider information is wrong, it may impact not only members’ access to care but also the level of member-payer trust.
Features
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What are the differences between Medicare Parts A, B, C, D?
Medicare includes four different segments that each insure a wide variety of services and supplies for enrollees.
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Data, technology strategies boost payer patient education
Analytics platforms, omnichannel engagement tools, telehealth, and other technological and data advancements have been pivotal to successful payer patient education.
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A VBC approach to improving pediatric behavioral healthcare access
Behavioral healthcare access for children and adolescents is lacking, but payers can use value-based care systems to increase and optimize referral opportunities.
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How to accelerate value-based care despite looming healthcare crisis
Centering provider and member experience will be key to accelerating value-based care in the coming years.