Author: Scott Welch
Millions of consumers will feel the pinch when rates already expected to rise will jump even further. Federal subsidies, set to expire at year’s end, are partly to blame.
The Centers for Medicare & Medicaid Services (CMS) this week released new data fueling a narrative of rampant broker fraud on the Affordable Care Act (ACA) exchanges. Plans received data finding 23% of enrollees did not have a claim in 2019. That number jumped sharply to 35% last year. Before the pandemic, the data were ...
A new analysis from the Congressional Budget Office (CBO) warns that Republicans’ massive tax bill could lead to hundreds of billions in cuts to Medicare over the next 10 years. CBO analysts, in a letter (PDF) to key Democratic senators Friday, dug into the potential impact the One Big Beautiful Bill Act could have on federal programs ...
As the Trump administration moves forward with sweeping tariffs aimed at increasing U.S. manufacturing, health systems are ramping up efforts to protect patients from potential effects. At Renton, Wash.-based Providence, COO Darryl Elmouchi, MD, said the health system has implemented a supply chain risk management program to help prepare for challenges with respect to tariffs. ...
National pricing data show the cost of healthcare services varies greatly by payer, geography, setting and facility, presenting new fiduciary considerations for employers. Since 2022, health plans have been required to release machine-readable files disclosing negotiated rates of healthcare services with providers. Hospitals are also required to release the costs of shoppable services. Data analytics ...
The Affordable Care Act (ACA) introduced Medical Loss Ratio (MLR) requirements for fully insured medical plans. These rules require insurers to spend a substantial portion of premium dollars on actual health care services and quality improvements. In turn, they limit the dollars that can go toward administrative costs like marketing, salaries, agent commissions, and profits. The MLR ...
Amid pressure from the White House, U.S. drug companies are experimenting with direct-to-consumer sales models that cut out the middlemen.
The partnership between GoodRx and Novo Nordisk represents a seismic shift in the diabetes drug sector, redefining pricing power and market access for GLP-1 receptor agonists (GLP-1RAs). By slashing the cash price of Ozempic and Wegovy to $499 per month for self-paying patients, the collaboration not only addresses affordability gaps but also positions both firms ...
President Trump on Wednesday ordered his health officials to secure a six-month supply of advanced pharmaceutical ingredients for drugs the administration determines are critical for national health and security. Why it matters: The move continues efforts started during the Biden administration to reshore the medical supply chain and reduce the reliance on overseas manufacturers, especially China. The government ...
As small businesses navigate an uncertain economic environment, many are still looking to expand or maintain their health benefit offerings, according to a new report from Chase. The report surveyed 563 small business owners in June for the annual midyear check-in on their business and found that 80% currently offer health coverage for their employees, with half ...