COVID-19 could depress 2021 Medicare Advantage payments, analysis suggests

Consultancy Avalere also warned that MA plans should brace for dealing with chronically ill enrollees whose health has declined due to foregoing care during the pandemic and could require more services in the long term.

By Ron Shinkman • Nov. 9, 2020

Biden names COVID-19 experts, calls pandemic top priority for transition

The transition team added three members to the advisory board late last week, including a Seattle nurse and former union organizer, the executive director of the Navajo Nation Department of Health and a former OSHA administrator.

By Shannon Muchmore • Updated Dec. 1, 2020

Explore the Trendline➔

Surprise Billing

Federal legislation banning surprise bills has hit a barrage of roadblocks, complicating efforts to protect consumers from unexpected out-of-network charges.

By Healthcare Dive staff

Coronavirus vaccine from Pfizer, BioNTech prevents COVID-19, early results show

The results, from a large Phase 3 trial that began in late July, cap off a dizzying eight months of research, into which scientists at Pfizer and German drug developer BioNTech compressed what's normally a yearslong process.

By Jonathan Gardner • Nov. 9, 2020

Healthcare helped Democrats usher in 2018's blue wave. This year it hasn't delivered a decisive win.

"Clearly, the ACA message wasn't the salient issue of the election as it seemed to be in 2018, but we did see healthcare playing a big role," Chris Sloan, a principal at consultancy Avalere, said.

By Samantha Liss • Nov. 6, 2020

Biden faces a divided Congress, stifling chance for more progressive health policies

Former Vice President Joe Biden won the U.S. presidency, the Associated Press and all the major networks said, after votes were tallied in Pennsylvania on Saturday.

By Shannon Muchmore • Updated Nov. 7, 2020

CMS finalizes rejection of Baxter, Outset dialysis device add-on payments

The broader, now final, end-stage renal disease rule is meant to support use of equipment and supplies for at-home dialysis treatment.

By Nick Paul Taylor • Updated Nov. 3, 2020

What healthcare issues are driving voters to the polls on Election Day?

While the economy has topped the list of concerns in some national surveys, the Affordable Care Act's Medicaid expansion and pre-existing condition protections are also key issues on voters' minds.

By Hailey Mensik • Nov. 3, 2020

Healthcare Dive's 2020 election coverage

The outcome of the presidential race and control of the Senate were still unknown. Polling showed healthcare issues were top of mind for many as they cast their vote.

Nov. 2, 2020

CMS set to bump MA rates for 2022 in win for payers

The agency is also proposing to rely entirely on encounter data to calculate patient risk scores in 2022, a move that has been opposed by commercial insurers.

By Samantha Liss • Nov. 2, 2020

CMS clears Georgia bid to nix Healthcare.gov, decentralizing ACA marketplace

If implemented, the state would be the first with no government-run website to enroll in ACA plans, decentralizing marketplace functions among a few private insurers. Some call it an illegal move that would push thousands off the rolls.

By Rebecca Pifer Parduhn • Nov. 2, 2020

Aetna to pay $1M to settle 3 patient data HIPAA breaches

The potential violations all occurred over a six-month period in 2017 and affected a total of more than 18,000 members, the HHS Office for Civil Rights said. The payer is not admiting liability.

By Shannon Muchmore • Oct. 29, 2020

Second interoperability deadline extension likely final delay, ONC chief says

Some health IT experts have criticized the delays, arguing that free and unfettered data sharing could help the country coordinate its pandemic response as the U.S experiences a third spike in COVID-19 cases.

By Rebecca Pifer Parduhn • Oct. 29, 2020

Trump admin pushes back interoperability deadline for second time

The move was expected — rumors swirled for weeks amid public comments from top health IT officials and a proposed rule with a title hinting at deadline extension — but is a significant increase in the timeline for compliance.

By Rebecca Pifer Parduhn • Oct. 29, 2020

CMS requires government, most private plans to cover COVID-19 vaccines

Commercial payers are likely already modeling costs. Anthem CEO Gail Boudreaux said Wednesday the insurer considered multiple variables when determining pricing and will follow CMS guidance.

By Shannon Muchmore • Updated Oct. 29, 2020

Final rule requires health plans to make negotiated rates public

CMS Administrator Seema Verma fought back against claims the regulation will stifle competition. "Don't be fooled ... such complaints are all about protecting a considerable profit special interest reaped from business as usual," she said.

By Shannon Muchmore • Oct. 29, 2020

Gilead's Veklury becomes first FDA-approved drug for treating COVID-19

The U.S. regulator granted a full approval after allowing emergency use earlier this year. New results from a WHO study, however, raise questions about the drug's ultimate effectiveness.

By Ben Fidler • Updated Oct. 23, 2020

4 healthcare storylines overshadowed by COVID-19

The magnitude of the crisis has all but stopped some efforts, like a ban on surprise billing. But other policies are forging ahead, including price transparency requirements for hospitals beginning Jan 1.

By Shannon Muchmore • Oct. 22, 2020

HHS walks back CARES fund reporting requirement hospitals feared

The department said it had earlier concerns that some providers would wind up more profitable than they were before the COVID-19 pandemic.

By Samantha Liss • Updated Oct. 23, 2020

From back-to-work to telehealth to retail rebranding: HLTH 2020 takeaways

Trump administration officials also provided an update on value-based care models, teased details of the coronavirus vaccine's approval and hinted at a coming reimbursement plan.

Oct. 21, 2020

COVID-19 has sparked more concerns about healthcare costs, insurance, TransUnion says

More people, especially those in younger generations, are using insurer websites to conduct cost research, the annual survey found.

By Ron Shinkman • Oct. 21, 2020

CMS approves controversial Medicaid waiver in Nebraska, creating 2-tiered system

The expansion is a more creative way to implement work or job training requirements, but opponents argue it will deprive some enrollees of benefits.

By Samantha Liss • Oct. 21, 2020

Providers' rocky road to recovery could last into 2022

About 20% of hospital executives told Kaufman Hall they were "extremely concerned" about their financial viability, as the Midwest reports rising COVID-19 caseloads and providers prep for the pandemic to collide with flu season.

By Shannon Muchmore • Oct. 20, 2020

ACA plan premiums to fall 2% in 2021, CMS says

The price easing comes despite the Trump administration's efforts to chip away at the law, including support for the case to overturn it now before the Supreme Court. But affordability remains a challenge for some who don't get subsidies.

By Rebecca Pifer Parduhn • Oct. 20, 2020

CVS wants pharmacy techs to administer COVID-19 vaccine, plans to hire 10,000 more

This week the Trump administration released guidance authorizing pharmacy technicians and pharmacy interns to administer coronavirus vaccines and COVID-19 diagnostic tests.

By Rebecca Pifer Parduhn • Updated Oct. 23, 2020

Retail's role, focus on equity, value-based pay amid COVID-19: takeaways from HLTH 2020

Back-to-work products, coronavirus vaccine distribution and telehealth ROI were also hot topics at the conference's third year.

By Rebecca Pifer Parduhn • Oct. 19, 2020