Payer Strategy & Health Insurance
Expert articles and analysis related to payer strategy & health insurance.
AI Summary â Last 30 Days
Synthesis:
Over the past 30 days, the Centers for Medicare & Medicaid Services (CMS) has initiated a structural shift in value-based care by selecting over 150 participantsâincluding major digital health firms like Verily and Noomâfor the new Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model. ACCESS, launching July 5, emphasizes voluntary participation and "lean" payment structures that tightly link provider reimbursement to measurable chronic disease outcomes enabled by technology partners, particularly for conditions like obesity, diabetes, musculoskeletal pain, and depression. This policy move signals a deliberate acceleration of technology-driven, outcomes-based payment models, setting a new precedent for how Medicare may align incentives and expand digital care access within population health management, with significant implications for payer strategy, ACO operations, and risk-bearing providers aiming for scalable value-based transformation (details here).
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Insurers have Cut Prior Auth by 11% Following Commitments  MedCity News
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Insurers have cut prior auth requirements by 11%: AHIP-BCBS
Insurers have cut prior auth requirements by 11%: AHIP-BCBSÂ Â Becker's Hospital Review