The current dual-system model is inefficient, wasteful, and inconvenient. There is a clear need to integrate workers’ comp and medical benefits programs to cut down on costs and alleviate the hassle of dealing with separate care silos. It’s possible, and its time has come.

Insurtechs like Bright Health Group, Clover Health and Oscar Health set out to disrupt health insurance — but have they actually done so? Not in a positive way, several experts say.

Many insured Americans reported challenges with their insurance coverage in the last year, especially those in poorer health and those with mental health conditions, a KFF survey found.

The $58 million funding round was led by Portage and included participation from PruVen Capital, Wing Venture Capital and others. With the funding, Angle Health plans to expand into additional markets and grow its membership.

An Oscar Health survey found that about 93% of respondents are “extremely,” “very” or “somewhat” concerned about the state of the economy. Another 44% of respondents listed the economy as their top healthcare concern.

More than 31% of people with employer-sponsored insurance stuck with a job they disliked for the company’s health insurance, a Forbes Advisor survey found. Another 8% of respondents left a job they liked to seek better coverage.

Average annual premiums in 2022 reached $7,911 for single coverage and $22,463 for family coverage, the KFF survey showed. This is only a slight increase from last year at $7,739 and $22,221, respectively.

Many startups are giving patients options to receive care that cuts out insurers. This includes online pharmacies, direct primary care platforms and lending companies. These startups are creating change among payers, some experts say.

Notably, in the list, the so-called disruptors of the insurance industry are the ones whose CEOs appear to be winning financially even though their stock performance has left much to be desired.

When asked what their biggest difficulties are today, 46% of payer leaders said managing costs and 41% said driving operational efficiencies. The reason for this could be increasing claims volumes from the Covid-19 pandemic, rising costs from people delaying care and the use of outdated systems, the survey said.

Many employed Americans misunderstand their health insurance plans, and 72% want someone to just tell them what the best plan is for their specific needs, the survey found.

Skyrocketing medical bills and a lack of understanding in the healthcare system is putting financial stress on Americans in 2022, several recent reports have found. Despite the No Surprises Act, which protects consumers from surprise billing, many Americans said they’re still receiving unexpected bills, and a low healthcare literacy is making it difficult for them to know how to handle high medical bills, the surveys find.

Value-based healthcare puts the focus on patient outcomes, but payers have a part to play as well. A panel at MedCity News’ INVEST conference discussed how reimbursement strategies can improve patient care and reduce costs.

Acting Assistant Secretary for Employee Benefits Security Ali Khawar vows to do whatever is necessary, including suggesting Congress authorize fines, to finally bring insurers into compliance with the 2008 mental health parity law.

Included Health, a benefits navigation startup for LGBTQ+ employees, recently landed two big clients, Walmart and State Farm. CEO Colin Quinn explained the company’s journey so far and why more benefits leaders are paying attention to LGBTQ+ employees’ health needs. 

Value-based contracts covering the reimbursement of drugs and medical devices are slowly gaining acceptance. A panel at the MedCity News INVEST conference discussed the challenges and opportunities for these contracts, which aim to improve patient outcomes and control the cost of care.

Unless the Supreme Court strikes down the ACA, it will remain in place for the foreseeable future and will see expansion.

After a scathing report from short-seller Hindenburg claiming that Clover faced a False Claims Act investigation, the insurance startup’s stock plummeted. Clover went public last month after merging with a special-purpose acquisition company under billionaire investor Chamath Palihapitiya.  

PolitiFact and Kaiser Health News teamed up to analyze Biden’s promises during the 2020 presidential campaign and will monitor his policies over the next four years to see which ones materialize.

Starship, a startup making Health Savings Accounts easier to use, has seen an influx of users since the start of the pandemic. In the first six months of 2020, the company saw 500% growth in active accounts and plans to double its membership again by the end of the year.

The plans will include zero-dollar premiums and will give patients access to free primary care visits, dental exams and lab tests at Walmart Health centers across the state.

After seven years, David Boies eyes the finish line for his clients in the Blue Cross Blue Shield class action.

Shawn Wagoner, chief revenue officer of insurance startup Bind Benefits, and Michael Yang, managing partner of OMERS Ventures, debated the best approach to help patients pick their insurance benefits.

Venture capitalist Michael Yang, Managing Partner, OMERS Ventures, and healthcare entrepreneur Shawn Wagoner, Chief Revenue Officer, Bind Benefits, will debate how the future of health insurance can be reimagined and the limits to doing that. It will be followed by a networking event on the Remo platform.

Cigna plans to add marketplace plans in 79 new counties next year, part of a planned expansion on the individual exchanges.

Alphabet’s healthcare subsidiary, Verily, will partner with Swiss Re Corporate Solutions to create a new stop-loss insurance company. The new entity, called Coefficient, will use data analytics to help self-funded companies manage unexpected areas of cost.

UnitedHealth Group saw its earnings nearly double to $6.6 billion during the second quarter, as fewer patients sought out appointments or non-essential procedures due to the pandemic.

Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.    

When CMS approved telehealth as a means for health plans to gather risk adjustment data it made the right move, as it is critical for Medicare Advantage (MA) plans to stay on track with risk adjustment.

Health Rosetta Founder Dave Chase developed a method to help self-insured companies reduce healthcare costs. The company also certifies insurance brokers to better represent companies’ best interests in designing health plans.