The Latest
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Deep DiveHospital price transparency push draws industry ire, but effects likely limited
While few would argue for secrecy for its own sake, policy analysts say there's little evidence patients use the information now available to make decisions that could bend the cost curve.
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Supreme Court to hear $12B risk corridor case next term
The Chamber of Commerce urged the court to take the case, warning that if the government is allowed to renege on its promised payments it could scare off the business community from working with the government.
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Deep DiveIndustry interoperability concerns plague TEFCA draft
ONC's "on-ramp" to nationwide connectivity is being dogged by many of the same issues as its interoperability regulations, including implementation, standardization and privacy.
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Shareholders overwhelmingly approve Centene-WellCare union
This isn't the final hurdle for the $17 billion deal, which still awaits approval from more than 20 states.
UPDATED: June 25, 2019 at 10:30 a.m. -
UPMC-Highmark ink 10-year contract after years of fighting
The reconciliation comes less than a week before a deadline that would cut off Highmark-insured patients from access to many UPMC facilities.
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AHIP19: Insurers acknowledge heightened cost pressures
"We really do have to tackle head on the issue of affordability," Matt Eyles, CEO of AHIP, said during the lobby's annual conference.
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CVS, government urge federal judge to bless settlement pact
The American Medical Association, AIDS Healthcare Foundation and consumer groups argued against the Justice Department's settlement of CVS' $69 billion buy of Aetna in briefs ahead of a July 17 oral argument.
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Trump order to force hospitals to reveal information behind negotiated rates
Providers and payers will be required to give patients estimates for out-of-pockets costs for procedures in advance under an executive order the president is expected to sign Monday. A legal challenge is likely.
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Not 'a build it and they will come kind of thing': Telehealth descends on AHIP19
Doctor on Demand and Teladoc were among the telehealth players that descended on the insurance industry's annual meeting this week to tout services aimed at helping payers bend the cost curve.
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Social determinants of health the buzzword at AHIP19
A new initiative aims to bring together payers from different markets and geographies to work together on establishing programs to combat social inequities that negatively affect health.
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Surprise billing fixes would ding hospitals, staffing companies, Moody's says
Legislative proposals to end the practice of surprise billing are mostly credit negative for providers, but fixes that include bundled billing or an in-network guarantee would have the worst effect.
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UnitedHealth's acquisition of DaVita physician group gets FTC approval
Under an agreement reached with the federal agency, the payer will divest the medical group's Las Vegas practice to Intermountain Healthcare.
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AHIP19: Cigna CEO says 'society demands more' from industry
David Cordani addressed consumer frustration and the industry's need to improve, especially when it comes to curbing costs, opening the payer group's annual conference.
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Geisinger cements interim chief exec Jaewon Ryu as CEO
Ryu has served as the integrated health system's interim chief executive since November 2018 and will be the seventh CEO in Geisinger's 104 years of operation.
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At AHIP19, a call to 'break glass' to survive fast-changing industry
Panelists at AHIP, including former CVS head Andy Slavitt, called for disruption across healthcare, including increasing partnerships among providers, payers and home health companies.
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Court says CVS exec's move to PillPack violated noncompete
Jefferies analysts said the case documents show Amazon is seeking to bypass pharmacy benefit managers and contract directly with payers for its services, a negative signal for the PBM industry.
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Senators differ on best approach to ban surprise billing
Senate HELP Committee Chairman Lamar Alexander, R-Tenn., seemed to support a guarantee that any care received at an in-network facility would be covered by a patient's insurer, a measure opposed by the provider lobby.
UPDATED: June 19, 2019 at 1:41 p.m. -
Public option, increased premium credits could save $12B
Such changes would also provide coverage for an additional 1.2 million people, according to a report from the Urban Institute.
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Mount Sinai joins LabCorp to adopt Philips' digital pathology
The clinical lab giant will integrate the system into Mount Sinai's eight hospitals, enabling remote review of images and surgical slides.
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Providers ready to take on more risk, survey shows
A Navigant survey of 170 hospital and healthcare system senior finance executives shows 72% plan to take on additional risk over the next one to three years.
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Health execs overconfident on data privacy, industry poll finds
Seven in 10 healthcare companies are very confident or extremely confident in their ability to manage sensitive data, yet just half update their inventory once a year or less, according to a survey by Integris Software.
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Fitch forecasts healthy cash flow for providers despite pressures
"Questions of access and affordability at the heart of the healthcare reform debate are critical to profitability of healthcare providers over the longer term," the ratings agency said in a new report.
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Civica Rx contracts with Vizient to anticipate drug price, availability
Vizient will analyze purchasing patterns and hospital needs through its data and analytic offerings to help ease generic drug shortages for Civica's 900-plus member hospitals.
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3rd Cir.: Hospital admin terminated for cost reasons, not bias
The former employee said her firing was linked to the cost of her husband's cancer treatments, which he received at the hospital.
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CMS proposes rule to set Part D electronic prior authorization standards
Under the standard, providers can use an electronic prescribing system or EHRs to determine whether a plan requires prior authorization for the medication being prescribed and submit the information in real time.
