Plus, Marc Cuban’s drug company gets first deal with Blues plan

This Week

Oct 15, 2022

Medicare Advantage at the tipping point: A preview of 2023 open enrollment

Mark Cuban Cost Plus Drug Company announces first health plan partner, Capital Blue Cross

Humana joins forces with USAA for new co-branded MA plan for veterans - Robert King

 

Featured

Medicare Advantage at the tipping point: A preview of 2023 open enrollment

Medicare Advantage enrollment starts this week as the program is more popular than ever. This report details some of the key trends and issues to watch out for, from star ratings to risk adjustment.
 

Top Stories

Major worldwide study clusters long COVID symptoms into 3 groups

Healthcare systems around the world facing the challenge of diagnosing long COVID might benefit by separating the symptoms of the disease into three general clusters.

Bright Health to exit ACA exchanges, slash MA footprint to 2 states

The insurtech has announced that it is axing its full lineup of plans on the Affordable Care Act's exchanges and cutting its Medicare Advantage offerings to two states for the 2023 plan year.

Blue Shield of California sues state over Medi-Cal changes that benefit Kaiser Permanente

Blue Cross of California sued that state’s Department of Health Care Services over Medi-Cal changes that would greatly increase Kaiser Permanente's Medicaid reach.

Survey: Employers rein in health benefits for pre-Medicare and Medicare-eligible retirees

Employers predict that they will have to pay more over the next three years for pre-Medicare and Medicare-eligible retiree health plans. They’re seeking solutions.

Medicare Advantage star ratings show steep declines for 2023 as pandemic flexibilities go away

Half of Medicare Advantage plans with prescription drug coverage next year will feature four or more star ratings, a drop compared with 68% in 2022, new CMS data show.

Health insurers can run, but they can't hide: Tough long COVID coverage decisions on the horizon

The elusiveness of generally agreed-upon diagnostic and treatment tools for long COVID begs the question: What should health plans pay for?

Biden administration finalizes rule to get rid of ACA's 'family glitch'

The Biden administration finalized a rule on Tuesday that gets rid of the Affordable Care Act's "family glitch" which inadvertently drives up healthcare costs for certain families.
 
Fierce podcasts

Don't miss an episode

'Podnosis': How the primary care market is changing, honoring executives of color making a difference

This week on "Podnosis," we talk about the trend of retail giants getting involved primary care. Also under discussion is our special report spotlighting the important contributions made by people of color across health systems, physicians' offices, health tech and insurance companies. 
 

Resources

eBook

Harness the Power of Cloud-Based Data and Analytics to Personalize Healthcare and Improve Patient Outcomes

Personalize the healthcare journey with a data-driven platform.
Whitepaper

No Surprises Act: Winning the Dispute Resolution Game

Learn how payers and providers can improve outcomes in No Surprises Act Dispute Resolution by leveraging AI to guide arbitration offers.
Whitepaper

The Time has Come to Reinvent the Patient Experience

This report highlights the challenges, opportunities and costs associated with improving the patient intake process and other elements of the patient experience. Read now to learn how healthcare organizations are leveraging digitization to reimagine the patient, clinician and staff experience.
Whitepaper

How Vida Addresses SDOH for Better Diabetes Outcomes

Social determinants of health such as limited grocery options, socioeconomic status, and lack of access to technology keep many of your members from achieving positive diabetes outcomes. Learn more about how SDOH factors impact your members’ chronic conditions and how Vida can help.

Whitepaper

Unifying the Digital & Physical Building Hospital Resilience

Learn how IT and facility security professionals are collaborating on key initiatives to mitigate digital and physical security risks and build resilience healthcare system-wide.

Whitepaper

6 Components for Building a Successful Telehealth Infrastructure

With Telehealth growing faster than any other place of care, implementing robust telehealth systems is a priority for healthcare organizations. Learn what those essential components to building a successful telehealth infrastructure are, and how they can provide a seamless experience for both patients and onsite clinicians.