New & Notable
Top stats on Medicare Advantage enrollment, costs in 2025
Two new analyses from KFF identify key trends in Medicare Advantage enrollment and costs in 2025, including lower premiums and growth in special needs plans.
High Part D premium hikes in CMS' crosshairs for 2026 bids
CMS said it has, for the first time, rejected some standalone Medicare Part D standalone plan sponsors because they imposed significant premium increase.
UnitedHealth faces DOJ investigation after fraud accusations
DOJ has launched an investigation into UnitedHealth Group after several reports that the payer engaged in inappropriate billing in the Medicare Advantage program.
Humana to reduce prior authorizations for outpatient services
Humana will eliminate a third of prior authorizations for outpatient services by 2026 and publicly report its prior authorization metrics in an effort to increase transparency.
Insights
Insights is research conducted by and for TechTarget Xtelligent Healthcare. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Sponsored Sites
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Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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As healthcare premiums rise, consumers might feel the pinch
Two reports detail healthcare premium hikes for 2026, which can impact consumers through higher costs and limited employer coverage options.
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Payers buy more primary care practices, boost MA penetration
A new study shows that payers have significantly integrated with primary care practices, especially in markets with higher Medicare Advantage penetration.
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Key healthcare takeaways from Trump’s spending bill
President Trump signed the tax and domestic policy megabill into law, putting in motion massive Medicaid cuts and work requirements, among other healthcare-related provisions.
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National health expenditures to reach $8.6T by 2033: CMS
CMS projects national health expenditures to increase by 5.8% from 2024 to 2033, reaching $8.6 trillion by the end of the period as the last of the Baby Boomers age into Medicare.
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Major health plans pledge to simplify prior authorizations
Dozens of U.S. health plans vowed to implement six actions to standardize, streamline and reduce prior authorization, AHIP announced.
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CMS finalizes changes to ACA Exchange eligibility process
CMS' finalized changes to the ACA Exchange eligibility process focus on verification to weed out what it claims is waste, fraud and abuse.
Features
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UnitedHealthcare's provider search tool hinges on consumerism
UnitedHealthcare designed its provider search tool to fulfill the growing demands of healthcare consumerism while nudging the user toward high-value providers.
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Key features of a health insurance member portal
Member portals will be key as health insurance companies adjust to healthcare consumerism and prioritize better member experiences.
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How this payer achieved mental health parity accreditation
Blue Cross Blue Shield of Minnesota says it achieved URAC's mental health parity accreditation because it employs a dedicated team focused on mental health access.
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Exploring Transparency in Coverage schema 2.0, prescription drug prices
Federal agencies unveiled updates to Transparency in Coverage, mandating a new technical schema that promises to improve data and floating prescription drug price transparency.