Payer
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CVS wants pharmacy techs to administer COVID-19 vaccine, plans to hire 10,000 more
The drugstore giant already has pharmacy technician immunizers in five states: Idaho, Rhode Island, Utah, Michigan and Nevada, and is currently training technicians to administer vaccines in Washington state.
By Rebecca Pifer • Oct. 19, 2020 -
CMS
MA plans see more minorities, dual eligibles signing up
Medicare Advantage has been a key revenue driver for big payers like UnitedHealth and Cigna, which are expanding their footprints.
By Shannon Muchmore • Oct. 16, 2020 -
Trendline
Social determinants of health
The focus on social determinants of health has only increased as the COVID-19 pandemic has devastated the United States.
By Healthcare Dive staff -
Brian Tucker / Healthcare Dive
CMS grants Medicaid waiver to Georgia; exchange opt-out remains on table
CMS approved a modest Medicaid expansion waiver for Georgia on Thursday, and is apparently nearing OK of a second waiver that would allow the state to opt out of the Healthcare.gov insurance exchange.
By Ron Shinkman • Oct. 15, 2020 -
CMS expands Medicare emergency telehealth coverage with 11 new services
The agency also said more than 36% of those in traditional Medicare used a virtual visit between March and August and usage among Medicaid members has skyrocketed.
By Rebecca Pifer • Oct. 15, 2020 -
UnitedHealth Group
UnitedHealth says Q3 volume rebounds, net income down on consumer price breaks
Still, the first payer to report quarterly earnings bested Wall Street expectations and saw a lower-than-expected medical cost ratio of 81.9% for the third quarter.
By Samantha Liss • Oct. 14, 2020 -
Payer competition shrinks in already scarce markets, AMA survey finds
The five insurers with the biggest share in the most markets were Anthem, Health Care Service Corp., UnitedHealth Group, Florida Blue and Highmark.
By Hailey Mensik • UPDATED: Oct. 15, 2020 at 10:02 a.m. -
Brian Tucker/Healthcare Dive
Teladoc-Livongo make first combined sale to Guidewell Health
The Florida Blue plan, which has been a Teladoc client for several years, will now offer Livongo's diabetes platform to some 50,000 members. Executives claimed more interest behind the scenes Monday at HLTH.
By Rebecca Pifer • Oct. 13, 2020 -
Getty Images
Medicare coronavirus vaccine pay rule predicted by month's end, Verma says: HLTH 2020
It's unclear whether CMS has the regulatory power to reimburse for a vaccine if approved by the FDA under an emergency use authorization, as public health officials expect. The rule will likely tackle that.
By Rebecca Pifer • Oct. 13, 2020 -
Employer healthcare costs stable in 2020, COVID-19 impact still unclear, KFF says
Still, despite modest premium growth, the annual Kaiser Family Foundation Employer Health Benefits survey notes costs for family coverage rose double the rate of inflation over the past five years.
By Ron Shinkman • Oct. 08, 2020 -
Fotolia
Medicare Advantage enrollees in 4-star or higher plans to drop in 2021
Cigna appears a winner as about 88% of its members will be in plans with four or more stars. Hitting higher scores gives plans the chance to nab lucrative bonuses.
By Samantha Liss • Oct. 08, 2020 -
Getty Images
Most employers won't turn to healthcare cost shifting in 2021, Mercer says
Months into a public health crisis, the outlook for employer-sponsored healthcare could shift significantly due to deferred care.
By Ryan Golden • Oct. 08, 2020 -
Walmart enters Medicare broker market, threatening incumbents
The massive retailer plans to sell MA, supplement and prescription drug plans from major insurers like UnitedHealthcare and Humana during this year's annual enrollment period.
By Rebecca Pifer • Oct. 07, 2020 -
Courtesy of Target
More than 14M may have lost health coverage after historic job losses, study finds
Not all lost jobs result in a loss of coverage, so researchers have been keen to figure out how historic unemployment has ultimately affected insurance status.
By Samantha Liss • Oct. 07, 2020 -
MA startup Clover Health goes public in blank check deal valuing it at $3.7B
The transaction expected to close in early 2021 is the latest in a string of IPOs and deals for digital-focused healthcare companies.
By Rebecca Pifer • Oct. 06, 2020 -
Medicare advisers toy with MA payment overhaul as major payers expand for 2021
MedPAC commissioners floated a new methodology in the Medicare Advantage program blending local and national spending, but pushback from payers is likely if the change is finalized.
By Rebecca Pifer • Oct. 05, 2020 -
CMS
UnitedHealth, Cigna to expand Medicare Advantage footprints, touting telehealth for 2021
Humana, Anthem and Aetna are also moving into new geographies with the popular and lucrative program. In addition, smaller player Clover Health is partnering with Walmart to offer plans in Georgia.
By Shannon Muchmore • Oct. 02, 2020 -
[Photograph]. Retrieved from Regional Health Command Atlantic.
Patients give high marks to telehealth, J.D. Power says
The survey of more than 4,300 people ranked Amwell and Doctor on Demand as well as insurers. Sicker patients were less likely to report a positive experience.
By Ron Shinkman • Oct. 01, 2020 -
Photography by Adam Schultz/Photo edit by Kendall Davis/Healthcare Dive
Deep DiveElection 2020: Trump and Biden's starkly diverging views on healthcare
Spoiler: the two nominees diverge on almost everything.
By Rebecca Pifer • Oct. 01, 2020 -
Getty Images
4M added to Medicaid rolls due to coronavirus pandemic
The job market — which many rely on for commercial insurance coverage — is likely to remain strained as long as the U.S. fails to contain the spread of the novel coronavirus. The resulting shift in payer mix is unfavorable for providers.
By Samantha Liss • Oct. 01, 2020 -
Dollar Photo Club
$6B fraud bust includes numerous telehealth schemes
Providers quickly pivoted many services to virtual care during the COVID-19 pandemic, potentially inviting fraud.
By Shannon Muchmore • Oct. 01, 2020 -
Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law
The law signed by the president Thursday is likely the only direct aid providers can expect before the November presidential election, after Congress deadlocked on further COVID-19 legislation.
By Rebecca Pifer • Oct. 01, 2020 -
Rangel, David. [photograph]. Retrieved from https://unsplash.com/photos/4m7gmLNr3M0.
Anthem to pay almost $40M to settle 2015 cyberattack investigation
The settlement ends a long-standing investigation into the payer following a series of targeted hacks that exposed the health information of almost 79 million people. Anthem continues to deny any wrongdoing.
By Hailey Mensik • Sept. 30, 2020 -
Fotolia
Provider finance execs bracing for unfavorable shift in payer mix, survey finds
About 70% of CFOs and revenue cycle leaders are readying for a drop in commercially insured patients — a highly prized cohort for providers and health systems.
By Samantha Liss • Sept. 30, 2020 -
Molina's $380M buy vastly boosts managed care footprint in New York
The acquisition of Affinity Health Plan will add 284,000 Medicaid members, a significant increase as the payer climbs the ranks in a state currently dominated by rival Centene.
By Shannon Muchmore • Sept. 29, 2020 -
Fotolia
CMS touts dip in Medicare Advantage premiums for 2021
SVB Leerink analysts point to Centene, Humana and UnitedHealthcare as payers best positioned to pick up more share next year.
By Samantha Liss • Sept. 25, 2020
