Worried about losing members if the enhanced premium tax credits (PTCs) expire at the end of 2022? Health plans and states can use business rules
What if You Could Predict Which Members Will Term as Soon as They Enroll?
Research and Discussion with an Aetna/CVS Executive Softheon joined Aetna/CVS and HCEG (Healthcare Executive Group) to discuss successful member
Lessons from 2008 on Combating Medicaid and Marketplace Coverage Losses
“Losing Medicaid coverage? Don’t worry, we automatically enrolled you into a Marketplace plan.” This was just one innovative approach the State of
What Your Health Plan’s CEO Should Know about Composable Technology Investments in 2022 and 2023
Health plan executive leadership recognizes the need to invest in technology to remain viable in 2022 and beyond. Composability allows you to adapt to
Building Softheon’s Health Insurance Predictive Model
Softheon developed a classification model to predict subscribers likely to experience a lapse in coverage due to nonpayment based on data collected
Impact of the Proposed Notice of Benefit and Payment Parameters on Exchanges, Health Plans, and Web Brokers
On December 28, 2021, the Centers for Medicare and Medicaid Services (CMS) issued its annual proposed Notice of Benefit and Payment Parameters (NBPP).
The Intersection Between Medicaid and Marketplace: Recap of a Softheon and USofCare Virtual Event
Medicaid and Marketplace experts came together to discuss methods to retain enrollees and navigate the end of the Public Health Emergency (PHE).
3 Ways to Boost Member Enrollment
Fully capitalize on the millions of Americans switching their health coverage during Open Enrollment by effectively converting enrollees into members.
Automating Binder Payments on Pay Now
Health plans participating in the ACA Marketplace should make it a top priority to effectuate coverage immediately after enrolling through Pay Now by