Payer
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Anthem launches app allowing patients to text with docs
In an on-demand world, the mobile offering is designed to give patients quicker and less expensive access to treatment.
By Samantha Liss • July 22, 2019 -
ACOs with 2-sided risk can cut cost, improve quality, study finds
A Blue Cross Blue Shield of Massachusetts population health program cut per-enrollee spending and resulted in more chronic disease management, according to research in the New England Journal of Medicine.
By Ron Shinkman • July 22, 2019 -
As unprecedented CVS-Aetna review wraps, few clues from judge
Although CVS is now operating and reporting results to Wall Street with Aetna included, the decision could have huge repercussions especially if the judge orders CVS to go beyond Aetna's divestiture of its Part D business.
By Dana Elfin • July 21, 2019 -
Judge upholds short-term plan expansion in Trump win against ACA
The plaintiffs, including the Association for Community Affiliated Plans, the National Alliance on Mental Illness and AIDS United, plan to appeal the decision upholding the controversial policy.
By Rebecca Pifer • July 19, 2019 -
UnitedHealth Q2 revenue growth fueled by Medicare, Optum
The insurance giant's revenues grew 8% year over year to $60.6 billion — a "solid start" to managed care organizations' reporting season, according to Jefferies analysts.
By Rebecca Pifer • July 18, 2019 -
High-deductible plans can offer more access to preventive treatment under new rule
Under the guidance, potentially life-saving healthcare services and products used to treat common chronic diseases can be covered as preventive services in high-deductible health plans before enrollees reach their annual deductible.
By Linda Wilson • July 18, 2019 -
Oscar to enter Medicare Advantage market in New York, Texas
For New York residents, the upstart health insurer is planning to sell an MA plan co-branded with Montefiore Health System. In Houston, it intends to partner with multiple providers.
By Shannon Muchmore • July 18, 2019 -
ACA premiums for unsubsidized consumers hit new highs
The average monthly premium for a family of two hit $1,000 per month in 2019, according to eHealth's analysis of data on the unsubsidized market.
By Samantha Liss • July 17, 2019 -
Spending on primary care paltry, but some states ramping up
Increasing spending on primary care lowers emergency department visits and hospitalizations, according to the Patient Centered Primary Care Collaborative's 2019 Evidence Report, but America isn't funding it.
By Rebecca Pifer • July 17, 2019 -
Surprise billing legislation saves $7.6B, trims premiums, budget watchdog says
The sweeping Senate bill, which also tackles drug costs and bars certain contracts between payers and providers, was passed out of committee with bipartisan support last week.
By Samantha Liss • July 17, 2019 -
CVS launches home hemodialysis device clinical trial
The drugstore giant, which now includes insurance heavyweight Aetna, said it can help reduce the $35 billion in Medicare costs associated with the treatment of end-stage renal disease.
By Shannon Muchmore • July 17, 2019 -
Surprise billing fight escalates as providers win arbitration add to House bill
Insurers and health policy experts are pushing back against the controversial change to the bill, which will let providers or payers appeal to an independent arbiter in cases where the median in-network rate tops $1,250.
By Rebecca Pifer • UPDATED: July 17, 2019 at 4:11 p.m. -
UnitedHealth to jumpstart Q2 results with eyes on volume, 'Medicare for All'
The healthcare giant will report its earnings Thursday, setting the stage for the rest of the season.
By Shannon Muchmore , Samantha Liss • July 16, 2019 -
CMS proposes Medicare cover acupuncture for patients in approved studies
Medicare doesn't usually cover alternative medical procedures, but the government is looking for ways to reduce the nation's dependence on highly addictive opioids for chronic pain.
By Rebecca Pifer • July 16, 2019 -
Participation in APMs, MIPS climbed significantly in 2018
Many physicians have rejected the programs, saying they contain too many rules and rely too much on expensive investments in EHRs.
By Ron Shinkman • July 15, 2019 -
CMS proposes new home infusion therapy benefit
Home infusion therapy allows for the delivery of certain drugs, such as anti-infectives, chemotherapy or treatment for immune deficiencies, with the use of a durable medical equipment pump at a patient's home.
By David Lim • July 12, 2019 -
Deep DiveACA's legal jeopardy: 4 questions
The embattled landmark law is again before jurists, this time a panel of the Fifth Circuit Court of Appeals. Arguments this week offered more insight into what's at stake.
By Shannon Muchmore , Samantha Liss , Dana Elfin • July 11, 2019 -
White House pulls drug rebate rule to relief of payers
Withdrawal of the rule, which drugmakers supported, puts greater focus on the administration's plans for an international price index for certain doctor-administered drugs.
By Ned Pagliarulo • July 11, 2019 -
Appeals court judge on ACA: 'Congress can fix this'
Two Republican-appointed judges hammered Democrats on whether the ACA's individual mandate was severable from the rest of the law and asked why Congress expected them to find a solution.
By Samantha Liss , Dana Elfin • July 10, 2019 -
UK testing Netflix-style payments to boost antibiotics development
Officials hope the model will overcome some of the obstacles that have stifled the commercial prospects for new antibiotics.
By Jacob Bell • July 10, 2019 -
Air ambulance industry on defense as surprise billing debate heats up
Emergency air service providers are warning of base closures if surprise billing legislation working its way through Congress passes.
By Samantha Liss • July 10, 2019 -
UnitedHealth backs Inspire Medical's sleep apnea implant
The massive private payer deemed the Minnesota medtech's neurostimulation system medically necessary in patients with obstructive sleep apnea who have already tried CPAP therapy.
By Maria Rachal • July 10, 2019 -
Trump executive order seeks to overhaul US kidney care
The government push for home dialysis will help major payers like UnitedHealth Group, Cigna, Anthem and Humana and interested companies like CVS Health move into the space.
By Rebecca Pifer • UPDATED: July 10, 2019 at 1:48 p.m. -
In win for pharma, Trump TV drug price rule struck down
The federal district court sided with a drugmaker coalition that argued the government overstepped its authority in trying to force price transparency in advertisements.
By Jonathan Gardner • July 09, 2019 -
Pharma stocks slide as industry mulls Trump drug price action
Drug pricing is back in the spotlight as politicians grapple with ways to bring down healthcare costs. While the meaning of the president's comments wasn't clear, Monday's market reaction was unambiguous.
By Ned Pagliarulo • July 09, 2019
