Payer Strategies & Relationships
Expert articles and analysis related to payer strategies & relationships.
AI Summary — Last 7 Days
Over the past week, the Trump administration’s CMS finalized Medicare Advantage (MA) payment increases and implemented new 2027 MA and Part D policies, signaling a strategic alignment with private insurers but prompting mixed reactions as payers balance higher revenue with mounting regulatory scrutiny and star ratings changes [Devdiscourse, Modern Healthcare].
Related Articles
Insurers have Cut Prior Auth by 11% Following Commitments
Insurers have Cut Prior Auth by 11% Following Commitments MedCity News
Insurers Cut 11% of Prior Authorizations, Expand Continuity-of-Care Protections
Insurers have cut prior auth requirements by 11%: AHIP-BCBS
Insurers have cut prior auth requirements by 11%: AHIP-BCBS Becker's Hospital Review
Group cutting prior authorizations by 11% includes Aetna, Cigna
Group cutting prior authorizations by 11% includes Aetna, Cigna Modern Healthcare
Insurers have eliminated 11% of prior auths under reform pledge
Insurers have eliminated 11% of prior auths under reform pledge Fierce Healthcare
How to win peer-to-peer calls: a medical director’s guide
I review your peer-to-peer calls. Here is why you keep losing. I sit on the other side of your peer-to-peer call. I am a physician medical director in utilization management. When you call to overturn...
Insurers committed to cutting prior authorizations have eliminated 11% so far
Last summer, major payers committed to pare back onerous prior authorization policies, to the skepticism of providers. Now, AHIP and the Blue Cross Blue Shield Association are providing an update on i...
Health Plans Reduce Prior Authorization, Support Continuity of Care and Enhanced Consumer Communications
Health Plans Reduce Prior Authorization, Support Continuity of Care and Enhanced Consumer Communications AHIP
Reducing Scope of Claims Subject to Prior Authorization
Reducing Scope of Claims Subject to Prior Authorization AHIP
AHIP and BCBSA Letter on Improving Communications Related to Prior Authorization Notifications
AHIP and BCBSA Letter on Improving Communications Related to Prior Authorization Notifications AHIP