AHIP Solutions SmartBrief
Plus: Whooping cough outbreaks rise
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November 21, 2025
 
 
AHIP Solutions SmartBrief
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Top Story
 
Expiring ACA credits threaten affordable health care access
If the enhanced Affordable Care Act tax credits are not renewed, premiums for the 24 million people who rely on these subsidies could rise sharply, with estimates indicating a family of four might see monthly costs jump from $460 to $700. This increase would strain household budgets and could force individuals to forgo necessary care. The potential expiration of the tax credits could also have wider economic effects because of delayed hiring and possible layoffs, and health plans and providers may see decreased revenue.
Full Story: MedCity News (11/20)
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The Three Pillars of COB Success for Health Plans
Reduce medical costs and improve member satisfaction with a stronger coordination of benefits program and a complete payment integrity strategy. Read the eBook.
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Emerging Trends
 
Epic, Humana partner on digital insurance cards
Epic's Payer Platform will store digital insurance cards for Humana Medicare Advantage subscribers, facilitating appointment check-in at health care offices using Epic's system. Health care practices that use the system will be able to obtain patients' coverage details electronically.
Full Story: TechTarget (11/18)
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Cigna introduces AI-driven health plan
Cigna Healthcare has introduced Clearity, a health plan designed to enhance transparency and predictability. The plan, which has a tiered copay model that eliminates coinsurance and deductibles, uses Cigna's AI tools to provide upfront pricing and patient reviews through a streamlined digital platform. The plan provides "a simpler, more predictable way for customers to get the health care they need," said Eva Borden, Cigna's chief product officer for its commercial insurance business.
Full Story: Fierce Healthcare (11/18)
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Survey explores health care workers' views on technology
The Center for Generational Kinetics conducted a survey for health technology firm WellSky exploring health care workers' attitudes toward technology. Many see technology as essential for improving efficiency and reducing administrative burdens, but others worry about job displacement, data accuracy and the adequacy of training as technology continues to be integrated into health care.
Full Story: Medical Economics (11/19)
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Medical Update
 
WHO reports increasing drug-resistant gonorrhea
The World Health Organization has reported sharp increases in drug-resistant gonorrhea. Resistance to the two primary antibiotics, ceftriaxone rose from 0.8% to 5% and cefixime from 1.7% to 11% between 2022 and 2024. The antibiotics are the last recommended treatments for gonorrhea, but two new antibiotics have shown promise for treating the sexually transmitted infection.
Full Story: Center for Infectious Disease Research and Policy (11/19)
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Whooping cough outbreaks surge across multiple states
Whooping cough cases are surging nationwide, particularly in California, Florida, Oregon and Texas, driven by declining vaccination rates, waning immunity and improved testing, according to health officials. Infants are at the greatest risk, and the CDC urges pregnant women to get the Tdap vaccine to protect them. Health experts say increased vaccination and awareness are needed to combat the outbreaks.
Full Story: CBS News (11/19)
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Health Plan Company News
 
 
Blue Shield of California Promise Health Plan Launches New Initiative to Support Moms and Babies in First Year After Childbirth
 
 
City of Chattanooga and BlueCross BlueShield of Tennessee Foundation Break Ground on BlueCross Healthy Place at Airport
 
 
CVS Health Names David Joyner Chair of the Board of Directors
 
 
Health Net and Centene Foundation Invest $1.1M to Combat Food Insecurity in California
 
 
Humana: New Survey Offers Important Insights into How Medicare Advantage Beneficiaries Use and Value Their Supplemental Benefits
 
 
Magellan Behavioral Health of Pennsylvania Starts as New HealthChoices BH-MCO
 
 
 
 
Solutions Provider News
 
 
Cohere Health Ranked Among North America's Fastest-Growing Companies on the 2025 Deloitte Technology Fast 500
 
 
 
 
The Most-clicked Stories in Yesterday's Newsletter Were ...
 
 
Study identifies 8 distinct paths for long COVID symptoms
HealthDay News (11/19)
 
 
CVS Health: Becoming America's most trusted health care company
 
 
Nature-based exercise offers mental health benefits
Psychology Today (11/16)
 
 
 
 
Pharma News
 
Researchers pursue innovative therapies for autoimmune diseases
Researchers are exploring innovative treatments for autoimmune diseases, focusing on reprogramming the immune system to offer more effective and precise therapies. This includes CAR T therapy, T cell engagers, and the use of regulatory T cells. These new approaches are designed to target the root causes of immune dysfunction rather than just suppressing symptoms, offering hope for more sustainable disease management.
Full Story: The Associated Press (11/14)