Payer
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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.
By Samantha Liss • Dec. 11, 2019 -
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.
By Rebecca Pifer • Dec. 11, 2019 -
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.
By Rebecca Pifer • Dec. 11, 2019 -
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.
By Linda Wilson • Dec. 11, 2019 -
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.
By Samantha Liss • Dec. 10, 2019 -
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.
By Shannon Muchmore • Dec. 10, 2019 -
New life in surprise billing ban as key lawmakers reach agreement
With little time left in the session, a bipartisan group of committee leaders said they had reached a deal, but industry groups are stuck in their lanes.
By Shannon Muchmore • Dec. 09, 2019 -
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.
By Rebecca Pifer • Dec. 09, 2019 -
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.
By Rebecca Pifer • Dec. 09, 2019 -
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.
By Samantha Liss • Dec. 09, 2019 -
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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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.
By Ron Shinkman • Dec. 06, 2019 -
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.
By Rebecca Pifer • Dec. 06, 2019 -
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."
By Shannon Muchmore • Dec. 05, 2019 -
Medicare Advantage members rarely review or switch plans
A Kaiser Family Foundation analysis found that more than one in three Medicare beneficiaries reported difficulty comparing plan options and nearly half of those on Medicare said they rarely or never review their choices.
By Shannon Muchmore • Dec. 04, 2019 -
Deep DiveWill sky-high drug prices spur the US to use an obscure power over patents?
New cell therapies as well as gene-based treatments like Zolgensma benefited from NIH funding of early-stage research. Advocates say the time is now for the government to invoke its "march-in" rights.
By Jonathan Gardner • Dec. 04, 2019 -
Senators push CMS, commercial payers on bias in algorithms
The letters sent to UnitedHealth, Blue Cross Blue Shield, Cigna, Humana and Aetna flagged a study that found racial bias in a widely used algorithm for assessing healthcare needs.
By Susan Kelly • Dec. 04, 2019 -
Hospitals sue HHS, warning price transparency rule would chill competition, crash computers
An agency spokeswoman shot back that hospitals "should be ashamed that they aren't willing to provide American patients the cost of a service before they purchase it."
By Samantha Liss • Dec. 04, 2019 -
Anthem, Passport to protest $7B Kentucky Medicaid contract loss
Aetna, Humana, Molina, UnitedHealthcare and WellCare were the winners in the bid to provide coverage to about 1.3 million Medicaid members.
By Samantha Liss • Dec. 03, 2019 -
Centene sells Illinois plans to CVS in next step for WellCare buy
Centene has already divested its Medicaid managed care business in Nebraska and Missouri as it nears completion of the $17 billion acquisition of its rival.
By Samantha Liss • Dec. 02, 2019 -
Global Blood's sickle cell drug wins FDA approval, joining Novartis' Adakveo
A list price of roughly $10,000 a month puts Global Blood's Oxbryta slightly higher than what Novartis' Adakveo will cost.
By Jonathan Gardner • Nov. 26, 2019 -
Walgreens, UnitedHealthcare team up to open in-store Medicare centers
The move comes as rival retailers like CVS and Walmart devote more floor space to health services. The 14 stores will open next year in five metro areas.
By Samantha Liss • Nov. 26, 2019 -
Standards body urged to add device identifiers to insurance claims forms
Advocates say such a policy change would improve patient safety and save the healthcare system money by allowing better tracking of implants by brand and model.
By Susan Kelly • Nov. 26, 2019 -
Mandatory CMS radiation oncology model goes on backburner
Originally, the agency was eyeing an implementation date as early as Jan. 1, but the new regulatory agenda lists July 2022 as a target date for the bundled payment model.
By David Lim • Nov. 26, 2019 -
ColumnMyth Diagnosis: Is healthcare recession-proof?
"That's a little bit of a misnomer," Ben Isgur, health researcher at PwC, told Healthcare Dive. "It is a little recession-resistant, but eventually that wears off."
By Shannon Muchmore • Nov. 22, 2019
