The Latest
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Amazon's PillPack inks 1st digital pact with payer in BCBS Massachusetts
The Blues plan will target the offering to the 12% of its beneficiaries that take five or more maintenance medications, and the 43% that take between two and four, a spokesperson told Healthcare Dive.
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Sponsored7 solutions to address physician burnout
Physician dissatisfaction is a complex issue, and there are ways besides improving the EHR that healthcare organizations can help to improve physician satisfaction.
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Kaiser interim chief Greg Adams named full-time CEO
Adams has been at the nonprofit for over two decades and previously served as a group president overseeing hospital and health plan operations, including Kaiser's Medicare care delivery strategy.
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Few Medicare Advantage plans add new benefits for serious illness
Starting this year, CMS gave the plans flexibility to offer more benefits for nonmedical services like home-based palliative care, adult daycare services, bathroom safety devices and modifications.
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Value-based pricing for gene therapy? Maybe not ready for hemophilia
Small patient population plus large potential savings could make blood clotting gene therapies an easier sell to payers, biotech execs say.
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Surprise billing ban draft: Middle ground leaves few pleased
The bill backed by a bipartisan group of Senate and House leadership would require insurers pay at least the median in-network negotiated rate for the area market for out-of-network services and has an arbitration backstop.
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Dive Awards
Provider of the Year: Providence St. Joseph Health
The 51-hospital system, which traces its roots back to the 1850s, has maintained a stable ratings outlook amid industry headwinds, and pursued a number of tech partnerships this year to bolster its portfolio.
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Health insurers stable, M&A seen diminishing in 2020: Fitch
Despite a projected increase in the growth of U.S. health spending, the ratings agency expects insurers to deliver healthy operating results including improved medical loss ratios for 2020.
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SponsoredHow AI can help health plans become member-centric
Improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement.
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Dive Awards
Payer of the Year: Centene
Centene's blockbuster acquisition of WellCare doubled its Medicare Advantage footprint and positions the company to be the leader of government-sponsored plans.
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Dive Awards
Disruptor of the Year: The Affordable Care Act lawsuit
An unexpected ruling at the end of 2018 invalidating the ACA paved the way for even more uncertainty for the landmark law, following a decade of upheaval. The case is nearly certain to end up before the Supreme Court.
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Nonprofit hospitals get bump in Moody's ratings for 2020
The investor service predicts a healthier sector in the new year, though health systems will still contend with headwinds like rising labor costs, an aging population and political uncertainty.
UPDATED: Dec. 11, 2019 at 9:01 a.m. -
Dive Awards
The Healthcare Dive Awards for 2019
From the Affordable Care Act lawsuit to CVS Health CEO Larry Merlo, these are the companies, executives and movements that shaped U.S. healthcare this year.
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Health insurance coverage linked to reduced mortality
In a sweeping study of millions of households, researchers found that people were more likely to sign up for health insurance once prodded.
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UnitedHealth to acquire embattled specialty pharmacy Diplomat for $300M
The payer giant's offer of $4 a share for the roughly 75 million shares outstanding is a relatively lowball offer, sending Diplomat's stock down 31% in premarket trading Monday.
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Dive Awards
Executive of the Year: Larry Merlo, CVS Health
Merlo has a vision for the future of the industry, and he's leveraging all of the retail giant's many assets to try and get there.
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Supreme Court to hear $12B ACA risk corridors case this week
The justices will consider the case Tuesday. Observers say the money will not be the ultimate thrust of the court's decision — it's whether the business sector will have trust in the federal government in current and future partnerships.
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Biotech's Alzheimer's pitch polarizes scientists
Two large clinical trials testing Biogen's drug aducanumab in patients with less advanced disease looked negative after early analyses, leading the company to stop them before they finished.
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Competing House surprise billing plan muddies path of White House-backed legislation
The House Ways and Means Committee unveiled its own surprise billing legislation Wednesday that relies on arbitration.
UPDATED: Dec. 12, 2019 at 9:21 a.m. -
More than 1K employers push Senate to repeal ACA Cadillac tax
AHIP and the U.S. Chamber of Commerce were among those arguing the tax will have sweeping effects beyond just "gold-plated" health coverage and will raise costs for the millions of Americans with employer coverage.
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US healthcare spending growth rebounded last year, influenced by insurance tax
Hospital and physician and clinical services spending fell, but prices were up. CMS Administrator Seema Verma blamed provider consolidation and the "creation of monopolies."
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Value-based care payments increasing but risk still rare
Bundled payment adoption, for example, remained flat between 2012 and 2017 despite studies showing their promise in holding down costs, the Catalyst for Payment Reform found.
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Roche MRSA test wins FDA OK
The agency said the novel diagnostic technology can deliver results in as little as five hours, compared to the one- to two-day wait time with conventional methods.
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Kaiser mental health worker strike back on, with potential hit to 100 clinics
The five-day strike now planned to begin Dec. 16 had been postponed following the death of CEO Bernard Tyson.
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More state laws back telehealth, but many stop short of mandates
While regulations have inhibited growth in the past, many states are warming up to the adoption of virtual services. That's a "sea change compared to a decade ago," Foley & Lardner lawyers said.
