Payer Systems

Why Does Employer Size Matter for Your Medicare Enrollment?
Management & Administration Why Does Employer Size Matter for Your Medicare Enrollment?

Group health plans sponsored by small employers do not automatically remain primary for spouses once they reach the Medicare eligibility age of sixty-five. This nuance often surprises individuals who believe that remaining on a working spouse’s insurance provides a seamless safety net. In reality,

Why Are Rural Retirees Losing Medicare Advantage Coverage?
Management & Administration Why Are Rural Retirees Losing Medicare Advantage Coverage?

Major insurance carriers like UnitedHealthcare and Humana are exiting hundreds of rural counties while expanding their presence in urban centers by comparison. This trend highlights a growing instability in the private healthcare market that previously promised competitive choices for every

Can Medicare for All Save a Trillion Dollars and 100,000 Lives?
Management & Administration Can Medicare for All Save a Trillion Dollars and 100,000 Lives?

The widening gap between commercial insurance rates and Medicare payment rates has contributed to a ballooning of national health expenditures that continues to outpace the rate of inflation. As the United States navigates the complexities of its modern healthcare landscape, the debate over a

Does Medicare Pay for Nursing Home Hospice Room and Board?
Management & Administration Does Medicare Pay for Nursing Home Hospice Room and Board?

Even when a hospice provider coordinates care, the underlying contract for the nursing home bed remains a separate financial obligation for the family or the state. The transition to end-of-life care is often a time of immense emotional strain, frequently exacerbated by a significant

Kentucky Redefines Inmate Medical Care Costs to Ease County Burden
Management & Administration Kentucky Redefines Inmate Medical Care Costs to Ease County Burden

The fiscal strain on local budgets due to rising incarceration costs has reached a critical juncture in the Commonwealth. New administrative rules effective as of August 17 establish a clear distinction between the minor healthcare services counties must pay for and the expensive treatments the

Alabama Education Health Plan Faces $222 Million Shortfall
Management & Administration Alabama Education Health Plan Faces $222 Million Shortfall

A $222 million funding gap is threatening to force difficult choices regarding the healthcare benefits provided to Alabama’s teachers and retirees. The Public Education Employees’ Health Insurance Plan (PEEHIP) of Alabama is currently navigating a precarious financial landscape, characterized by a

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