Payer
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Adeline Kon/Healthcare Dive
Deep DiveA look at Teladoc's primary care strategy from its head of US group health
In an interview, Kelly Bliss teased upcoming clients for a new virtual-first primary care product and parsed out Teladoc's growth strategies for 2022 and beyond.
By Rebecca Pifer • Oct. 27, 2021 -
Samantha Liss for Healthcare Dive
Centene looks to sell non-core assets, bounces back from Q2 loss
The insurer rebounded in the third quarter as patient utilization returned to more normal levels and revenue increased 11% year over year.
By Samantha Liss • Oct. 26, 2021 -
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Julia Rendleman via Getty Images
Cigna expands telehealth benefits for employer-covered lives, including new virtual-first plan
The virtual-first plans will initially be available to large, self-insured employers, though the insurer is looking to expand to smaller sized and fully insured clients over time.
By Rebecca Pifer • Oct. 26, 2021 -
Fotolia
Large purchaser coalition PBGH forms new venture to lower employer health costs, starting with PBM launch
Emsana is the latest independent venture from employer interests looking to disrupt the healthcare industry, a task easier said than done.
By Rebecca Pifer • Oct. 25, 2021 -
CMMI wants every Medicare beneficiary in an accountable care plan by 2030
Officials acknowledged provider concerns that current models are too burdensome and benchmarks too complex, which the innovation center aims to fix.
By Hailey Mensik • Oct. 21, 2021 -
Anthem again hikes outlook for 2021 after Q3 medical costs beat expectations
Medical costs came in below projections despite the wave of COVID-19 hospitalizations and cases that were fueled by the delta variant during the quarter.
By Samantha Liss • Oct. 20, 2021 -
Alex Wong via Getty Images
In last ditch plea to save MCIT, medtech groups suggest fixes to CMS
AdvaMed and MDMA responded to a call for feedback on the planned repeal of the Medicare Coverage of Innovative Technology pathway by proposing tweaks and new ideas to salvage it.
By Nick Paul Taylor • Oct. 20, 2021 -
Rebecca Pifer/Healthcare Dive
UnitedHealthcare to launch virtual-first primary care plan by end of year, COO says
The company is seeking to capitalize on the preference for home-based and telehealth care, a trend that took off during the pandemic.
By Rebecca Pifer • Oct. 19, 2021 -
Rebecca Pifer/Healthcare Dive
Amazon teases 5 more cities to get virtual Amazon Care offering this year
Amazon Care is currently live in the Washington, D.C. and Baltimore area, and will be rolled out in Dallas, Chicago, Philadelphia, Boston and Los Angeles this year, the unit's director told the HLTH conference Tuesday.
By Rebecca Pifer • Oct. 19, 2021 -
Courtesy of Walmart
Walmart, Transcarent partner to pitch self-insured employers
The retail giant will make its low-cost prescription drugs, along with its optical, telehealth and other services available to self-insured employers while leveraging Transcarent’s digital platform.
By Hailey Mensik • Oct. 18, 2021 -
Spencer Platt via Getty Images
What to expect from payer, provider Q3 earnings
The intense volume of COVID-19 patients that came from the delta surge will likely influence winners and losers for the third quarter. Results ramp up this week.
By Samantha Liss • Oct. 18, 2021 -
UnitedHealth Group
UnitedHealth, with profit up 29%, expects contested Change acquisition to close early 2022
The closing news is likely to anger hospital groups, which have raised concerns the deal could hurt health IT competition and give the payer an unfair advantage in contract negotiations. DOJ is investigating the deal.
By Rebecca Pifer • Oct. 14, 2021 -
Retrieved from Abbott/PRNewswire on June 15, 2020
Abbott, Dexcom could benefit from CGM use jump among Type 2 diabetes patients: report
The population could drive the next wave of demand for devices to track and control diabetes, Jefferies analysts predicted, following a recent CMS coverage change that rolled back restrictions to CGM access.
By Susan Kelly • Oct. 13, 2021 -
CMS
Medicare Advantage, Part D plans with 4 or more stars soaring, CMS says
About 90% of people currently enrolled in MA plans offering prescription drug coverage are enrolled in a plan that will earn four stars in 2022.
By Hailey Mensik • Oct. 11, 2021 -
Molina to buy AgeWell's long-term care business in New York for $110M
As part of the deal, Molina will pick up about 13,000 people covered by AgeWell's long-term care services. In 2020, the premium revenue generated from these members was about $700 million.
By Samantha Liss • Oct. 08, 2021 -
Alex Wong via Getty Images
Feds OK health plan discounts for coronavirus vaccination
Such rewards must meet certain requirements, however, including a rule that they not exceed 30% of the cost of employee-only coverage.
By Kate Tornone • Oct. 07, 2021 -
Michael Nagle via Getty Images
Deep DiveHow Morgan Health hopes to finally move the needle on employer health costs: 5 insights from a chat with the venture's CEO
Morgan Health learned a lot from Haven, but is a different beast with better knowledge of the buy-in needed to disrupt the health benefits space, CEO Dan Mendelson told Healthcare Dive.
By Rebecca Pifer • Oct. 07, 2021 -
Mario Tama via Getty Images
Air ambulance charges zoom upward for commercial insurers, but not Medicare
Allowed in-network charges for fixed-wing air ambulances rose 76.4% between 2017 and 2020, and now top $15,000, a new study by Fair Health found.
By Ron Shinkman • Oct. 04, 2021 -
Sarah Silbiger via Getty Images
FDA's real-world evidence push hampered by data challenges, 'million-dollar question'
While the agency wants to tap information like electronic health records and wearables to make pre- and postmarket decisions, these sources do not have the same quality controls as clinical trials.
By Greg Slabodkin • Oct. 04, 2021 -
Getty Images
MA premiums will dip as payers expand footprints
Cigna, UnitedHealth and Centene are all entering new areas for 2022, but analysts say benefit options show that bids from insurers are relatively conservative.
By Shannon Muchmore • UPDATED: Oct. 5, 2021 at 9:46 a.m. -
Samantha Liss for Healthcare Dive
Centene reaches $72M settlement with Illinois, Arkansas for alleged Medicaid overcharges
The two states allege Centene failed to disclose relevant discounts and inflated dispensing fees. The latest settlements come months after similar agreements were reached in Ohio and Mississippi.
By Samantha Liss • Oct. 01, 2021 -
Jose Luis Pelaez Inc/Blend Images
Doctors slam surprise billing rule that details dispute resolution process
The interim final rule established that existing rates in a provider's geographic area will be a strong anchor for final payment decisions by arbitrators.
By Shannon Muchmore • Oct. 01, 2021 -
iStock
Consumer satisfaction with telehealth fell from last year, J.D. Power finds
Among direct-to-consumer brands, Teladoc ranked highest for consumer satisfaction, followed by MDLive. Among payer-sponsored services, UnitedHealthcare ranked the highest.
By Hailey Mensik • Sept. 30, 2021 -
AMA calls out shrinking payer competition amid rising antitrust interest in Washington
The study by the physician group is the latest salvo in a messaging war between provider and payer lobbies as they work to shift the blame for rapidly rising medical costs.
By Rebecca Pifer • Sept. 29, 2021 -
Alex Wong via Getty Images
CMS defends proposal to nix MCIT pathway, but medtechs hold out hope
If the bid to repeal the breakthrough payment rule is finalized, the agency's CMO committed to an alternative pathway that evaluates devices for Medicare patients potentially via clinical trials, outcome registries and real-world data.
By Greg Slabodkin • Sept. 29, 2021
