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News from the week of June 27, 2025
2025 Scorecard on State Health System Performance: Fragile Progress, Continuing Disparities (Commonwealth Fund) – The Commonwealth Fund has released their 2025 Scorecard on State Health System Performance documenting progress in the uninsured rates across states.
16 House Republicans tell leaders Senate's Medicaid changes go too far, threaten pulling support (Fierce Healthcare) – Push back against the proposed Senate Medicaid cuts are coming from some Republican House members, the American Hospital Association and the Senate Parliamentarian has said that some key provisions violate Senate rules.
How Medicaid and SNAP Cutbacks in the “One Big Beautiful Bill” Would Trigger Big and Bigger Job Losses Across States (Commonwealth Fund) – A report from the Commonwealth Fund predicts that cuts to Medicaid and SNAP will result in the loss of 1.22 million jobs nationwide and State GDP’s are expected to fall by $154.3 billion.
CMS slashes ACA sign-up periods, tightens eligibility in final rule (Healthcare Dive) – A new final rule impacting ACA enrollment and eligibility is expected to shrink coverage numbers.
More than half of US teens have had at least one cavity, but fluoride programs in schools help prevent them (MedicalXpress) – A recent study found that school fluoride varnish programs can help reduce cavities. The paper provides recommendations for overcoming barriers including cost and participation.
Digital Discover: Consumer Searches Reveal Contact Lens Realities (Contact Lens Institute) – A new report reveals why eyecare practices may want to be prepared to address questions and concerns raised by consumers in online searches for contact lens information.
Deloitte: Healthcare finance leaders see policy, economic storms ahead (Fierce Healthcare) – A Deloitte survey of health care CFOs shows concerns about business conditions due to regulatory changes, economic uncertainties and tariff disruptions as well as changing consumer expectations.
News from the week of June 20, 2025
- 2020 to 2022 Saw Nearly 2 Million Annual Emergency Room Visits for Dental Issues (Mesabi Tribune) – Updated federal statistics show that nearly 2 million ER visits per year are related to dental issues, a slight improvement from previous reports.
- FTC growls at vision care providers over 'hiding' patient prescriptions (Benefits Pro) – The FTC has issued warning letters to nearly 40 contact lens providers after consumers continue to report difficulty getting their prescriptions.
- The Employer’s Dilemma: When the Fully Insured Plan No Longer Works, What’s Next for Employers? (MedCity News) – Employers are adopting new approaches to fully insured plans including ICHRA adoption, which is seeing bipartisan support amid scrutiny in Congress.
- KFF Health Tracking Poll: Views of the One Big Beautiful Bill (KFF) – Medicaid keeps gaining in popularity as Senate Republicans unveil their version of the budget bill that could cut it by $800 billion.
- MedPAC: A look at payments to MA plans for supplemental benefits (Fierce Healthcare) – MedPAC has issued a report on the steep growth in Medicare Advantage supplemental benefits spending by the government, rising from about $21 billion in rebates in 2018 to roughly $86 billion. The Commission is calling for greater transparency for spending and utilization for supplemental benefits including dental and vision.
- Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries (KFF) – KFF forecasts that 1.3 dual-eligible Medicare beneficiaries may lose Medicaid under the budget bill. Over 90% of older adults with Medicaid may find it harder to enroll in and maintain Medicaid.
- From Payers of Claims to Partners in Care: The 2025 Healthcare Consumer Study (HealthEdge) – A recent report highlights the growing importance of affordability, transparency, member engagement, and the role of emerging technologies like artificial intelligence (AI) in shaping consumer expectations..
News from the week of June 13, 2025
- Rising costs push employers to rethink benefits strategies: WTW (Fierce Healthcare) – A new survey from WTW finds rising costs are pushing employers to be more strategic in their benefits programs, focusing on getting better value from existing contracts or switching partners in an effort to improve outcomes and increase value.
- For VM's 2025 Top 50 U.S. Optical Retailers, Industry Grows Alongside Investments in People and Tech (Vision Monday - pages 16-32) – Vision Monday reports on the top optical retailers and provides some perspective on vision retail growth over the past decade.
- Predicting emergency department visits for non-traumatic dental-related conditions among Medicaid beneficiaries (Nature) – A recent study used machine-learning algorithms to predict non-traumatic dental-related ED visits. The models they developed could help identify high-risk Medicaid beneficiaries as well as key risk factors and provide insights for developing outreach and care management strategies.
- How Technology Is Personalizing Healthcare in 2025 (MedCity News) – Hyper personalized care delivered via technology is becoming a reality in health care. Patients increasingly expect faster, frictionless interactions with their providers and insurance companies.
- Claim denials reversed less often for patients earning under $50K, study shows (Fierce Healthcare) – A recent report found that “patients with household incomes below $50,000 per year were not only the least likely to have their denied claims contested but also the least likely to have their claim denials reversed”.
- KFF Health Tracking Poll: The Public's Views of Funding Reductions to Medicaid (KFF) – The current KFF Health Tracking Poll finds 54% of adults are concerned that reductions in federal Medicaid spending will negatively impact their ability to obtain and afford healthcare.
News from the week of June 6, 2025
- Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States (KFF) – KFF maps out likely federal Medicaid spending cuts and enrollment losses on a state by state basis and a new report looks at how these cuts and ACA subsidy expirations will impact providers.
- Trump’s ‘One Big Beautiful Bill’ Continues Assault on Obamacare (KFF Health News) – Experts are assessing potential impacts to the ACA from the House budget bill while state exchange directors make a plea to senators to extend ACA tax credits.
- HHS releases more detailed 2026 budget disclosing scope of cuts (Healthcare Dive) – HHS has released more details of its 2026 budget proposal including deep cuts to NIH as well as replacing institutes focused on dental, craniofacial and eye/neurological disorders with a new Institute of Neuroscience and Brain Research.
- Health insurance coverage costs soar 6% in 2025 (TechTarget) – An annual survey of health costs finds an annual average cost increase of 6.1% for a family of four over the past two decades, far outpacing wage growth.
- The Connected Patient Experience: 3 Tips to Empower Healthcare Delivery Through Innovation (MedCity News) – Patients expect high levels of convenience and better, more connected information regarding their health. A growing number of patients are using apps and wearables to track their personal wellness.
- CMS commits to tech initiatives to give Medicare patients, providers easier access to health data (Fierce Healthcare) – CMS has outlined several new tech initiatives including a national healthcare directory, as well as a national identity verification solution and digital insurance card for Medicare.
News from the week of May 30, 2025
- J.D. Power: Why commercial plans should be investing more in engagement, education (Fierce Healthcare) – A new survey finds customer satisfaction with their health plans continues to drop. The highest rated plans have invested in engagement, education and improved services often employing digital tools.
New Survey Uncovers Potential Gap in Consumer Awareness and Understanding of Healthcare Portal Security Practices (LexisNexis) – A new survey that looked at consumer usage and data security of healthcare portals finds opportunities for organizations to improve portal adoption and strengthen security while improving user experience.
By the Numbers: House Bill Takes Health Coverage Away From Millions of People and Raises Families’ Health Care Costs (Center on Budget and Policy Priorities) – The Congressional Budget Office has increased its estimate of the number of Americans likely to lose health coverage due to the new budget bill to 15.7 million people.
Utilization of Health Care Services by Medicaid Expansion Status (KFF) – A new KFF study looks at health spending and services in states that have adopted Medicaid expansion. The data shows that expansion states spend more per enrollee overall than non-expansion states and that nearly half of expansion enrollees have a chronic condition.
Proposed Medicaid Cuts Could Jeopardize Health Care Access for 3 in 10 Young Adults (Urban Institute) – The Urban Institute finds that proposed changes to Medicaid would negatively impact and create additional hurdles for the 3 in 10 young adults that access Medicaid as they transition to the workforce.
CMS Administrator Outlines His Vision for CMS at NFP Healthcare Investors Conference (JD Supra) – At a recent event, the new CMS Administrator said he is focusing on digital transformation of health care and eliminating “fraud, waste and abuse” as he seeks to put his mark on the agency.
News from the week of May 23, 2025
- Health Provisions in the 2025 Federal Budget Reconciliation Bill (KFF) – As details spill out regarding the House Republican’s “big beautiful” bill that passed earlier this week, KFF is tracking the impact on Medicaid and other health programs. One provision includes cuts to general Medicaid funding for states that use their own budgets to cover undocumented residents. Other concerns involve the impact on the Affordable Care Act, while some elements would impact HSAs and incentivize a shift to ICHRAs.
How State Medicaid Choices Eased Children’s Coverage Loss After COVID-19 (University of Pennsylvania) – The University of Pennsylvania looks at how some states were able to limit children’s CHIP coverage losses through continuous eligibility and streamlined processes during the "unwinding".
Senators reintroduce bill that seeks to reform prior authorization in Medicare Advantage (Fierce Healthcare) – Prior authorization reforms which could ease administrative burdens on providers and reduce care delays for patients have been reintroduced in a Senate bill while CMS is putting additional effort towards increasing MA plan audits.
How Payer-Provider Collaboration is Creating A More Patient-Friendly Healthcare Industry (HIT Consultant) – Successful payer-provider programs are helping solve problems and improve patient access.
CareQuest State Oral Health Dashboard (CareQuest) – New reports on oral health status by state and adult dental coverage are available from CareQuest.
The 2025 State of America’s Oral Health and Wellness Report (Delta Dental) – Delta Dental's annual report card dives into patient understanding of oral health and the practice of good oral hygiene across different generations.
News from the week of May 16, 2025
The GOP’s Trying Again To Cut Medicaid. It’s Only Gotten Harder Since 2017 (KFF Health News) – In Washington, the focus is on the 2025 budget reconciliation bill. The Congressional Budget Office notes that the measure would result in an additional 13.7 million Americans becoming uninsured by 2034. KFF has a tracker that is following specific provisions in the bill.
As MA growth slows, analysts urge optimism (Healthcare Brew) – Increases in regulations and higher utilization have forced plans to recalibrate how to price and market Medicare Advantage plans while more seniors opted for traditional Medicare than in previous years.
CMMI revamps strategy to focus on disease prevention, cost savings (Healthcare Dive) – The Center for Medicare and Medicaid Innovation is shifting its focus to preventing chronic disease.
FDA to pull prescription fluoride supplements from market (ADA News) – The ADA is reaffirming its support of fluoride supplements after the FDA announced plans to remove prescription fluoride supplements from the market.
Prevent Blindness Cheers the Reintroduction of ‘Early Detection of Vision Impairments for Children Act’ (Vision Monday) – Prevent Blindness is supporting a bill that would address children’s vision through grants to improve early identification and vision care coordination of potential vision problems.
The Vision Council's Research Webinar Reveals Trends in Managed Vision Care (Vision Monday) – New research finds consumers with individual eyecare plans had the highest levels of satisfaction, while Medicaid ranked lower due to limited allowances. Patients also gave high marks to providers that were able to assist with required paperwork.
News from the week of May 9, 2025
- Forrester: How payers can balance cost cutting with customer experience improvements (Fierce Healthcare) – A new report provides insights on ways to both improve the customer experience while effectively managing costs.
- Healthcare Associations Speak Out Against White House’s Plan for Massive HHS Cuts (HCI Innovation Group) – Healthcare groups and the public are voicing strong opposition to additional HHS cuts in the White House’s 2026 budget proposal.
- Medicare Advantage Insurers Often Use Rewards and Incentives to Encourage Enrollees to Complete Health Risk Assessments (HRAs) (KFF) – While most Medicare Advantage enrollees are in plans that offer rewards or incentives for completing a Health Risk Assessment, limited data makes it difficult to determine the impact on members.
- Responding to Federal Medicaid Reductions: Which States Are Most at Risk? (KFF) – A series of reports from KFF detail which state Medicaid programs are most at risk and what we might see in the form of provider tax regulations and per capita caps on the ACA expansion population.
- Congressional District Interactive Map: People with Medicare and Medicaid (Dual-Eligible Individuals) (KFF) – KFF is out with a map highlighting dual eligible membership across congressional districts.
- NADP Foundation Report: Addressing Retiree Oral Health Needs. An analysis of current dental coverage and recommendations for expanded coverage (NADP) – A new analysis reveals large gaps in dental coverage for individuals aged 55 and older, leaving nearly 31% of this group without coverage.
- 2025 Global Priorities Survey (International Insurance Society) – A survey of insurance executives from across different sectors reports their leading concerns include inflation, operational efficiency, AI and expense management.
News from the week of April 21, 2025
- Budget draft outlines Trump's plan to slash federal health programs (Healthcare Dive) – A draft document proposes additional large budget cuts as well as the elimination of several HHS programs. The proposal also assumes that ACA subsidies will not be extended by Congress.
- The Vision Council Consumer InSights Q1 2025 report shows signs of increased consumer spending on vision care products (Vision Monday) – A new report from Q1 2025 finds online purchases of contact lenses continue to grow and enrollment in managed care vision plans is trending down slightly while government-sponsored coverage is increasing as more people become eligible for Medicare.
- Oral health care use characteristics in a limited sample of Medicare Advantage beneficiaries, Medicare Advantage encounter data 2021 (Journal of the American Dental Association) – A recent limited study of 21 plans found that nearly 47% of Medicare Advantage beneficiaries accessed dental care at least once in 2021. In addition, researchers found that all facets of comprehensive dental care services are being used including diagnostic, preventative, restorative and specialty services.
- Medicaid on the bring? Perspectives from 23 healthcare voices as cuts loom (Fierce Healthcare) –Fierce Healthcare contacted a wide range of healthcare leaders to get their opinions on Medicaid health policy and areas that could benefit from improvement..
- 5 key facts about children with special health care needs and Medicaid (KFF) – A new KFF brief looks at characteristics of children with special health care needs and how Medicaid supports this population..
News from the week of April 14, 2025
- Older adults are using patient portals—some are getting charged for it (Medical Economics) – A new study finds increasing numbers of older adults are using digital tools to communicate with providers. However, many report being charged copays. A separate report from JD Power finds a plans digital experience can impact member satisfaction and renewal rates.
- 5 key facts about Medicaid coverage for adults with chronic conditions (KFF) – KFF looks at how Medicaid facilitates access to care for the three quarters of working age adults enrolled in Medicaid with one or more chronic conditions.
- How work requirements would affect Medicaid coverage in each expansion state (Robert Wood Johnson Foundation) – New research shows that 5 million people could lose Medicaid coverage due to added administrative hoops from federal work requirements, this report analyzes the impact in each state.
- 'Watching the clues': Uncertainty clouds Medicare broker conference (Fierce Healthcare) – Uncertainty was in the air at a recent Medicare brokers conference. Attendees wondered about the future of Medicare Advantage, how changes at HHS might impact programs and what issues might arise if ACA subsidies are cut. The growth in chronic special needs plans (C-SNP) was also of interest.
- The consistency of health insurance coverage in small businesses: industry challenges and insights (JP Morgan Chase) – A new JP Morgan report looks at financial issues facing small businesses when it comes to providing health insurance for their employees and how these challenges may be addressed through policy changes.
News from the week of April 7, 2025
- How will Trump's tariffs impact medicine and healthcare? (MedPage Today) – Shifting tariff policies could have a big impact on healthcare readiness due to potential shortages, additional FDA inspection requirements and a lag in increased reimbursements.
- Medicare Advantage dental benefits in 2025: Steady improvement or more of the same? (Health Affairs) –