3+ week, 2+ day ago   (392+ words) SCAN Health Plan and Costco are partnering to provide a suite of insurance products for seniors. SCAN Health Plan and Costco are partnering to launch a suite of insurance products focused on seniors, the companies announced on Tuesday. SCAN is…...

3+ week, 5+ day ago   (291+ words) KFF found that insurers denied 12%-18% of standard prior authorization requests in 2025, with significant variation among insurers and gaps in transparency. In 2025, Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14% and ACA Marketplace insurers denied…...

1+ mon, 1+ day ago   (332+ words) Healthcare continues to feel pressure: financially, operationally, politically, and culturally. Patients are more frustrated than ever with the cost of care and confusing billing practices. Clinicians are stretched to their limits with ever-increasing responsibilities. Payers are on the defense to…...

1+ mon, 1+ week ago   (786+ words) What if health plans could identify member decline before an avoidable hospitalization occurs? Real-time clinical visibility into long-stay SNF members uncovers risk earlier and drives better outcomes. The Long-Stay SNF Blind Spot Many organizations continue to rely on retrospective claims…...

1+ mon, 3+ week ago   (392+ words) The House Ways and Means Committee unanimously advanced a bill to reform Medicare Advantage prior authorization requirements. The Improving Seniors’ Timely Access to Care Act passed out of the House Ways and Means Committee unanimously on Wednesday, a move that…...

2+ mon, 15+ hour ago   (724+ words) Medicare Advantage has become the dominant way older Americans receive healthcare, but the program still lacks one key ingredient: a long-term commitment. In two decades, Medicare Advantage has more than quadrupled enrollment to surpass traditional Medicare. Today one of every…...

2+ mon, 3+ day ago   (393+ words) KFF found that ACA Marketplace insurers are proposing a median 14% premium increase for 2027, driven by rising healthcare costs and the expiration of enhanced premium tax credits. Affordable Care Act Marketplace insurers are proposing a median premium increase of 14% in 2027, according…...

2+ mon, 4+ day ago   (237+ words) Pearl's $110 million raise includes a $50 million equity investment led by Andreessen Horowitz with participation from Viking Global Investors, AlleyCorp and Ulysses Capital, as well as a $60 million debt facility led by Trinity Capital. Pearl Health, a healthcare technology company helping…...

2+ mon, 5+ day ago   (277+ words) The star ratings battle continues, this time with Elevance Health. Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to recalculate Elevance’s 2026 Medicare…...