Certifi, Inc

Kudos to Dean Health Plan, Inc. by Medica for being a steadfast supporter of the Share Your Holidays campaign for 17 years. Medica employees actively participate in fundraising and volunteering efforts and the company supports various community initiatives, including food drives and charity events. Learn more: https://hubs.ly/Q02YxR0J0

HealthEdge's latest survey reveals key trends and priorities for healthcare payers in 2025. A focus on digital transformation, AI, and enhanced member experiences is driving innovation in the industry. Key Findings: - Digital Transformation: Technology upgrades and digital initiatives are top of mind for many organizations. - AI Adoption: AI is gaining traction, with 15% of respondents investing in AI technologies to improve efficiency and decision-making. Learn more: https://hubs.ly/Q02YxtQq0

Arkansas Blue Cross and Blue Shield is introducing a new benefit to help its ACA members manage healthcare costs more effectively. Eligible members can use Paytient® to pay for medical expenses over time, interest-free. This benefit can help alleviate the financial burden of unexpected medical costs. By easing financial constraints, members can prioritize their health and seek necessary care. Learn more: https://hubs.ly/Q02YdzJ60

SCAN Health Plan, a leading Medicare Advantage provider, recently announced the launch of SCAN Allied (HMO), a new Medicare Advantage plan designed for specific populations of older adults. This expansion aims to provide tailored healthcare solutions that address the unique needs of diverse communities. Key Features of SCAN Allied (HMO): - Comprehensive Coverage: Includes a wide range of benefits, including $0 premiums and flexible allowances for dental, grocery, and fitness. - Culturally Aligned Care: Access to a network of culturally aligned providers and pharmacies. - Personalized Care: Tailored plans to meet the specific needs of different populations. Learn more: https://hubs.ly/Q02YcVFN0

A recent poll has revealed that a strong majority of Americans are satisfied with their employer-provided health insurance plans. Key factors driving this satisfaction include: - Comprehensive Coverage: Plans offer a wide range of benefits. - Affordability: Plans are affordable and help manage healthcare costs. - Choice of Providers: Plans provide access to a broad network of healthcare providers. Learn more: https://hubs.ly/Q02YcXG30

The next chapter for health care in the U.S. may be shaped by substantial shifts in policy if former President Trump returns to office. The Affordable Care Act (ACA) is one of the key areas that could see significant changes, with experts exploring three possible directions: 1️⃣ “Massive Changes” House Speaker Mike Johnson suggests that if Republicans maintain control, sweeping changes to ACA funding and Medicaid could be on the table. This could mean substantial cuts, potentially impacting millions who rely on these programs. 2️⃣ Technical Tweaks Only Some predict that Trump may focus on smaller adjustments rather than a full repeal, aiming for targeted "fixes" to ACA-related programs. 3️⃣ Slash and Burn? Others believe Trump could pursue aggressive cost-cutting measures, like reducing enrollment outreach funds or supporting health plans with fewer ACA protections, potentially raising premiums for sicker individuals. Learn more: https://hubs.ly/Q02YcQYT0

Just as smartphones, e-commerce, and cloud computing revolutionized their respective industries, voluntary benefits billing is on the cusp of its own technological transformation. Here's a glimpse into the future: - Outsourcing Billing Operations: Many insurers are turning to specialized vendors to streamline billing processes and reduce costs. - AI-Powered Accuracy: Artificial intelligence is enhancing data accuracy, identifying anomalies, and automating tasks to minimize errors. - Self-Service Platforms: Employers are increasingly taking control of the billing process through user-friendly self-service portals. - Accounting-Based Billing: This approach offers greater flexibility and accuracy, especially when handling adjustments and corrections. - Integrated Solutions: The integration of billing solutions with other core administrative functions will streamline operations and improve efficiency. Learn more: https://hubs.ly/Q02ZnbtD0

The Medicare Advantage landscape is evolving rapidly, presenting both challenges and opportunities for health plans. While the potential for growth and profitability remains significant, plans must navigate a complex regulatory environment and rising expectations from beneficiaries. Increased scrutiny from CMS, including stricter Star Ratings and payment models as well as rising healthcare costs and inflation are putting pressure on health plans. Implementing new technologies, managing data, and complying with regulations can be daunting, but intense competition among health plans is driving innovation and cost-cutting measures. Learn more: https://hubs.ly/Q02Yc-z_0

The third quarter of 2023 presented a mixed bag of results for major health insurers. While some companies, like UnitedHealth, continued to perform well, others faced significant challenges. UnitedHealth remains a dominant force in the industry, posting strong profits despite challenges, include the costs of the Change Healthcare cyberattack. Many insurers are grappling with increased utilization and lower-than-expected Star Ratings in Medicare Advantage. Meanwhile, the unwinding of Medicaid expansion has impacted some insurers, such as Centene and Elevance Health. Continued inflationary pressures and rising healthcare costs are affecting the bottom line for many insurers. Learn more: https://hubs.ly/Q02Yd03c0

The Department of Justice (DOJ) has filed a lawsuit to block UnitedHealth's proposed acquisition of Amedisys, a leading home health company. The DOJ argues that the merger would reduce competition and harm patients. The DOJ contends that the merger would eliminate competition between two major players in the home health market. Reduced competition could lead to higher prices and lower quality of care for patients. The merger could limit job opportunities and bargaining power for nurses. Learn more: https://hubs.ly/Q02YcJnV0