Payer & Payor Strategies
Expert articles and analysis related to payer & payor strategies.
AI Summary — Last 30 Days
Over the past 30 days, CMS under the Trump administration has boosted Medicare Advantage (MA) payments, driving insurer stocks higher even as many payers express reservations about underlying policy structures and future revenue sustainability, highlighting ongoing tensions between immediate profitability and long-term value-based care (VBC) alignment (US Boosts Medicare Advantage Payments, Sends Health Insurer Stocks Surging, [Why insurers aren’t cheering CMS’ Medicare Advantage increase](https://news.google.com/rss/articles/CBMilwFBVV
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CommonSpirit, Cigna go out of network in Tennessee, Georgia
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She Owed Her Insurer a Nickel, So It Canceled Her Coverage
When medical bills started rolling in, a teacher’s aide in Florida wondered why her insurance suddenly wasn’t covering them. The answer? She owed a balance of 5 cents, so her insurer canceled her poli...
Platinum Plans – Strategic Design Opportunity or Repeat of Past Mistakes?
The 2027 Actuarial Value Calculator creates a timely opportunity for health plans to reintroduce Platinum products—not as broad offerings, but as targeted, condition-specific strategies that can mater...
10 Things to Know About Medicaid Managed Care
Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
Payers, hospitals pan CMS' plan to bring non-network plans to ACA exchanges
Payers, hospitals pan CMS' plan to bring non-network plans to ACA exchanges Fierce Healthcare
Opinion | He Was an Insurance Executive. She’s a Doctor. They’re Divided.
Opinion | He Was an Insurance Executive. She’s a Doctor. They’re Divided. Health Leaders Media
Washington State Ousted This Health Insurance Lookalike. In Oregon, It Carries On.
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Farm Bureau Plans Are a Less Pricey Alternative to ACA Coverage — With Trade-Offs
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ICHRAs, a growth opportunity for insurers, face uphill battle
Employers are turning to Individual Coverage Health Reimbursement Arrangements to cut costs, but rising premiums and instability on the individual market pose challenges.