Payer
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Payers in ACA exchanges beginning to find success
A Kaiser Family Foundation review of data from the National Association of Insurance Commissioners found that payers’ MLR and gross margins have improved significantly in the ACA marketplace over the past two years.
By Les Masterson • May 18, 2018
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CMS weighing National Coverage Decision for CAR-T
The agency is considering whether there is enough evidence to support national Medicare coverage of the pricey cancer therapies.
By Lisa LaMotta • May 18, 2018
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Sharecare patient engagement platform picked up by BCBS Minnesota, Walmart
The Atlanta startup offers health risk assessments, symptom checking and targeted messaging to prompt healthy behaviors.
By Meg Bryant • May 17, 2018
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Cigna, Express Scripts SEC filings reveal roadmap, backstory of $67B deal
If either terminates the merger, it may owe the other company a $1.6 billion termination fee.
By David Lim • May 17, 2018
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GAO: Patients say fees for accessing medical records are excessive
The report also found that some patients aren't aware they can access their records, or that they can challenge providers who deny them.
By Meg Bryant • May 16, 2018
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Oscar looking to expand to more state ACA exchanges
The payer reported a profit in the first quarter of this year and significantly improved its medical loss ratio.
By Les Masterson • May 16, 2018
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CMS' Verma says no to Medicaid lifetime limits
The administrator said the agency is still closely working with states on other types of waivers.
By David Lim • May 16, 2018
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VA finalizes rule easing virtual care delivery
The rule allows VA providers to offer telehealth services across state lines regardless of licensing and regulation requirements.
By Meg Bryant • May 15, 2018
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Urban Institute pitches moderate plan to achieve comprehensive coverage
The proposal would keep most of the current healthcare structure in place, including employer-sponsored insurance, and could result in 16 million fewer people without insurance.
By Les Masterson • May 15, 2018
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Vermont all-payer ACO shows early success
Meanwhile, the federal government approved Maryland's request to expand its all-payer model. Beginning in January, across-the-board rates in the state will include hospital and non-hospital settings.
By Les Masterson • May 15, 2018
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Virginia weighs provider tax to fund Medicaid expansion
If approved, the state would become the 34th to expand its Medicaid program.
By Meg Bryant • May 15, 2018
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Up to 10% with ACA coverage could jump to association health plans
Those people are more likely to be young and healthy, so their absence will leave the marketplace plans with an unstable risk pool, according to an Actuary analysis.
By Les Masterson • May 14, 2018
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Health sector's share of US jobs hits new high
The industry is nearing full employment, according to an analysis from Altarum.
By Les Masterson • May 14, 2018
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Clover launches in-home primary care with genomic testing
The YouScript partnership includes free gene-informed medication management to reduce adverse drug interactions.
By Les Masterson • May 14, 2018
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Fewer Americans confident they can afford healthcare, survey finds
People who are insured through employer plans tend to feel more secure about healthcare costs than those with other types of insurance, according to the report.
By Meg Bryant • May 11, 2018
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Deep DivePharma breathes easy as Trump's drug pricing plan fizzles
While Trump vowed to bring drug prices down, pharma and biotech stocks jumped higher after his speech delivered few immediate actions.
By David Lim • May 11, 2018
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Report suggests standardizing Medicare Advantage bidding process
The authors estimated the changes would save the federal government $10 billion annually and reduce Part B premiums for both traditional and MA beneficiaries by about 2% per year.
By Les Masterson • May 11, 2018
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What was and wasn't said at HLTH 2018
Views from the C-suite at athenahealth, Fitbit, CVS Health and 23andMe were shared with the audience at the inaugural HLTH conference in Las Vegas.
By Jeff Byers • May 10, 2018
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CMS gives 213 hospitals highest rating for patient experience
The number of five-star ratings varied on individual metrics. For example, 309 hospitals received five stars for discharge information, but just 179 got five stars for pain management and only 112 earned five stars for cleanliness.
By Meg Bryant • May 10, 2018
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UnitedHealthcare says its bundle model shows improved health, reduced costs
The program, which focuses on knee, hip and spine procedures, reduced hospital readmissions and limited complications.
By Les Masterson • May 10, 2018
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Report shows health spending for privately insured varies widely based on geography, competition
The amount differs by a factor of three across the country, with half of the variation caused by hospital pricing differences and half by quantity, according to the study.
By Les Masterson • May 10, 2018
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Genetic test market exploding with 10 new tests a day, study says
The vast majority of genetic tests today are multi-gene tests, fueled by unmet medical needs and advances in sequencing technologies.
By Meg Bryant • May 09, 2018
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Trump wants to cut billions from CHIP
Congress reauthorized the Children’s Health Insurance Program for 10 years as part of a large spending package in February.
By Les Masterson • May 09, 2018
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CMS unveils strategy to improve rural healthcare
Objectives for the plan include advancing telehealth, empowering patients in rural communities and leveraging partnerships to achieve rural health goals.
By Les Masterson • May 09, 2018
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Payers propose hefty ACA exchange premium hikes
The higher rates insurers in Virginia and Maryland proposed were expected after the Trump administration zeroed out the individual mandate penalty.
By Les Masterson • May 08, 2018