Medical Loss Ratio (MLR) Carrier Update

The Affordable Care Act (ACA) requires health insurance issuers to provide information on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR).

Read More

5 Changes Health Plans Need to Make to Adapt to an Ever-Shifting Industry

Health insurance is a constantly evolving and complicated industry that continues to change with the needs of the people, and it's only getting more complicated by the day. With new regulations and guidelines, new technology for data management, and emerging preferences for user experiences, it's easy to feel lost as you navigate this evolving landscape with your business.

Read More

Federal Judge Requires Vaccines For California Prison Staff

A federal judge on Monday ordered that all employees entering California prisons be vaccinated or have a religious or medical exemption, as he tries to head off another coronavirus outbreak like the one that killed 28 inmates and a correctional officer at San Quentin State Prison last year. Inmates who want in-person visits or who ...

Read More

Healthcare 2025: Health Plans Look Ahead To Emerging Business Opportunities

In the past 18 months, the healthcare industry has been defined by a time of sustained innovation and continuing technology investment. Health plans recognize the opportunity to collaborate with providers to deliver more patient-centric care and remove cost from the system. As government regulations and market forces converge around these initiatives, now is the time ...

Read More

Dentists’ Organization Fights Plan To Cover Dental Benefits Under Medicare Expansion

The American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients, opposition that could prove pivotal as Democrats look to make cuts in their $3.5 trillion domestic policy agenda. Giving dental, vision and hearing benefits to the 60 million older and disabled Americans covered by Medicare will provide ...

Read More

KFF: Analysis Finds Out-Of-Pocket Spending On Dental, Hearing In Medicare Far Outweighs Vision Benefits

Out-of-pocket spending for hearing and dental care far outpaced spending for vision care among Medicare beneficiaries, a new analysis found. The analysis, released Tuesday by the Kaiser Family Foundation, examines out-of-pocket spending in 2018 and 2019 on traditional Medicare and Medicare Advantage on the three benefits. It comes as Congress is contemplating adding the three benefits ...

Read More

Hospital Finances ‘Not Out Of The Woods Yet’ As Delta Fuels High-Acuity Stays In August

Hospitals’ August financials bowed under the weight of the COVID-19 delta variant, albeit not nearly to the extent they did during the widespread disruption of 2020, per Kaufman Hall. According to the group’s latest monthly report on industrywide performance, upticks in new COVID-19 cases and hospital admissions maintained pressure on hospitals’ bottom lines. By most ...

Read More

UnitedHealth Group Develops Calculator That Allows Schools, Businesses To Simulate COVID Testing Programs

As schools and businesses weigh their options for tracking COVID-19 cases, UnitedHealth Group’s researchers have developed an online calculator tool these organizations can use to game out potential testing programs. The free tool allows users to simulate the financial cost as well as the likely number of false positives for several different testing options and frequencies. For ...

Read More

Healthcare Headache: CCSD Teachers To Rally At School Board Meeting, Following Frustrations With Health Insurance

Teachers are furious and frustrated with their health insurance for not paying up. Teachers Health Trust (THT Health) covers around 18,000 teachers and their dependents

Read More

UnitedHealthcare To Make Apple Fitness+ Available In Fully Insured Employer Plans

UnitedHealthcare is making Apple Fitness+ available to millions of members at no cost, the insurer announced Thursday. Beginning Nov. 1, members in fully insured plans who already own an Apple Watch will be able to sign up for a yearlong Apple Fitness+ subscription for free. This covers about 3 million members across most states, UnitedHealthcare said. Self-funded ...

Read More
arrowcaret-downclosefacebook-squarehamburgerinstagram-squarelinkedin-squarepauseplaytwitter-squareyoutube-square