More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or delays in care.
CMS is proposing major changes to Medicare Advantage Star Ratings, drawing mixed reactions from healthcare leaders.
How can AI benefit and improve patient outcome in the emergency department? Watch the latest episode to find out.
Several states and insurers have gold carding programs to streamline prior authorization. However, some say they're falling short.
SCAN Health Plan and Astrana Health recently launched SCAN Allied, a Medicare Advantage plan designed for the Asian older adult population. It includes access to a network of culturally competent providers, specialists and pharmacies from Astrana Health.
CMS recently announced that it is recalculating Medicare Advantage Star Ratings. It comes after two lawsuits on the issue.
During a panel discussion at AHIP 2024, several executives shared their healthcare calls to action, including leveraging AI and rebuilding trust.
Alan Murray on improving access for medical transportation.
Health systems have been increasingly dropping MA contracts, saying that they cause their organizations to lose too much money and result in dangerous patient care delays. To mitigate this issue, experts think large MA plans need to delegate more utilization management duties to health systems rather than handling it themselves.
In this episode, we discuss SCAN Health Plan's recent launch of SCAN Inspired, a Medicare Advantage plan designed for women.
Enrollment in Medicare Advantage is increasing, but the program has been drawing scrutiny from the government. Can the program be saved? One expert believes Medicare Advantage is a failed experiment. Another thinks that while the program has its flaws, it shows tremendous potential.
In a value-based partnership with ApolloMed, SCAN is launching a Provider Specific Plan called Compass. It is also announcing a Medicare Advantage plan designed for women called SCAN Inspired.
In a recent interview, Esperion president and CEO, Sheldon Koenig talks about the reality of statin intolerance and his company’s expansion into new diseases
Some of the highest-ranked Medicare Advantage plans are SCAN Health Plan, Humana, Excellus BlueCross BlueShield, UPMC for Life and Blue Cross Blue Shield of Texas, according to a new J.D. Power report.
Over the next 18 to 24 months, Humana will exit the Employer Group Commercial Medical Products business, which includes fully insured plans, self-funded plans and Federal Employee Health Benefit plans. The decision represents Humana's move to double-down on its Medicare Advantage business, one expert said.
Healthcare organizations need to have clear and specific goals in order to make real change in reducing health disparities, executives from SCAN Health Plan and CVS Health said. The insurer is tackling medication adherence in Hispanic members and flu vaccination rates in Black members, while the retailer is taking on women's health, heart health and mental health.
MedCity News interviewed CEOs of public companies, entrepreneurs, VCs and payers at the HLTH conference that concluded last week. They had a range of answers to the question. But one common theme emerged: Currently, everyone has a vise-like grip on expenditure.
The health plan offered through SCAN includes care navigation services from Included Health, in which members can receive assistance in finding peer groups, support groups and community resources. Members can also receive virtual behavioral healthcare through Included Health.