Elevance Health (Elevance) settled a class-action complaint alleging that its Anthem commercial health plans applied overly restrictive criteria to claims for residential behavioral health treatment. The plaintiffs alleged that the restrictive criteria violated federal mental health parity laws.  The plaintiffs also alleged that Anthem’s coverage focused on intervention for short-term crises, but not on medically…

Lyra Health, which provides mental health benefits for employers, acquired Bend Health Inc., which provides pediatric mental health care. Financial terms were not disclosed. According to the announcement, Lyra Health anticipates that the acquisition will enhance its pediatric and neurodiversity capabilities with more specialized providers, neuropsychological evaluations, and virtual intensive outpatient care to provide whole…

Throughout the U.S., as many as 760 rural hospitals are vulnerable to closure due to serious financial problems, and 314 of these rural hospitals are at immediate risk of closure due to the severity of financial problems, according to a report by the Center for Healthcare Quality and Payment Reform (CHQPR). The loss of a…

The total cost of care for the 5.6 million people in the United States living with dementia is estimated at $781 billion in 2025, and about 30% of the cost ($232 billion) is for medical and long-term care services. Another 30% of the total cost was for informal care provided by family and friends. About…

About half (49.7%) of all health care expenditures in the United States in 2022 were for people in the top 5% of the expenditure distribution, according to an analysis of the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey Household Component (MEPS-HC). The top 1% of people ranked by their health care expenditures…

An average of $334 billion per year was spent across all payers to treat key diet-related conditions, such as cardiovascular disease, diabetes, and breast and colon cancers, among American adults aged 18 years and older in 2021 and 2022. The estimate is based on an analysis of data reported to the Medical Expenditure Panel Survey-Household…

Across all payer types, the number of clinical professionals delivering integrated, mental health and primary care services using the Collaborative Care Model (CoCM) billing codes increased by at least a factor of five nationally between 2018 and 2022, according to a recent study. Adoption rates varied considerably between insurance coverage types and across different geographic…

About 64% of health care provider organizations expect a shift toward value-based care in 2025, compared to 2024, according to a recent survey. About 30% of organizations reported that 25% or more of their revenue is tied to value-based care (VBC) contracts, and about 13% reported that more than 50% of revenue was linked to…