New final federal regulations will also require plans and insurers to answer questions related to eligibility within five ...
Clear plan communications and careful provider network management may help.
From a plan design perspective, we believe sponsors should consider distribution options such as systematic withdrawals or partial distributions so participants can take ongoing or periodic ...
The lawsuit, filed by the families of two deceased Medicare Advantage members, alleged that UnitedHealth knowingly used a faulty AI algorithm to deny elderly patients coverage for extended care deemed ...
The U.S. Preventive Services Task Force helps determine which screenings and preventive services insurers must cover without ...
"I have patients increasingly coming to me saying, 'I hear it's not as expensive to get the pharmaceutical-grade branded ...
The older workforce growth outpaces total employment growth — 17.3% since 2014 compared to 11.7% overall.
More than 8 in 10 people aged 18 to 29 say it is important to be perceived by others as financially responsible.
Secondary (comorbid) conditions, long inpatient hospitalizations and injectable drugs are the biggest drivers of expensive claims, according to the latest High-Cost Claims and Injectable Drug Trends ...
If we want different outcomes, we may need a different approach. What if benefits design did not just encourage healthier behavior, but directly paid for it? Misaligned incentives and an unbalanced ...
Overall commercial plan drug spending at the plans in the Navitus analysis rose 8.4% between 2024 and 2025, to $120.08 per member per month, with increased use of the drugs contributing 3.2 percentage ...
The direct-to-consumer pharmacy worked best when patients faced cost-sharing bills over $15 for a generic drug.
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