Payer: Page 102
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Judge tosses Maryland lawsuit seeking to shield ACA
Meanwhile, four more states are seeking to join an appeal defending the Affordable Care Act after a Texas judge declared it unconstitutional in December.
By Meg Bryant • Feb. 4, 2019 -
Opinion
Changing how we pay for healthcare to promote high-quality care, eliminate waste
The fee-for-service model needs an overhaul to best serve patients, argue Suzanne Delbanco, Maclaine Lehan and Roslyn Murray of the nonprofit Catalyst for Payment Reform.
By Suzanne Delbanco, Maclaine Lehan, Roslyn Murray • Feb. 4, 2019 -
Payers balk at HHS proposal to end federal PBM rebates
America's Health Insurance Plans criticized the administration's decision as "well-intentioned but misguided." The payer lobby insisted that rebate savings go directly to consumers, saving them on premiums and cost-sharing.
By Shannon Muchmore • Feb. 1, 2019 -
Cigna posts revenue jump, but Wall Street not so impressed
The payer's CEO said the change to Medicare drug rebates HHS proposed Thursday won't have "a meaningful impact" on the company or its growth, but analysts question that outlook.
By Les Masterson • Feb. 1, 2019 -
States ill-equipped to oversee short-term plans
Officials worry consumers won't be fully informed about what they're purchasing after researching short-term plans, according to a study from the Georgetown University Center on Health Insurance Reforms.
By Meg Bryant • Feb. 1, 2019 -
Taylor McKnight/Healthcare Dive
California sees 24% dive in new ACA plan enrollments
State officials pinned the blame on loss of the federal tax penalty for people without health insurance, but CMS pushed back on that claim.
By Meg Bryant • Jan. 31, 2019 -
Advocate Aurora, Oak Street Health partner on senior primary care
The new clinic, in a Chicago suburb with more than 25,000 Medicare-eligible adults, will offer a range of both primary care and wraparound services.
By Meg Bryant • Jan. 31, 2019 -
CMS proposes more nontraditional benefits for MA plans
If the policy changes are approved, the expected average increase in revenue for 2020 Medicare Advantage plans is 1.59%, down from the 3.4% increase for 2019.
By Shannon Muchmore • Jan. 31, 2019 -
Report says AHPs offer complex benefits, but critics not appeased
UnitedHealthcare and some Blue Cross Blue Shield brands are selling the controversial plans.
By Les Masterson • Jan. 31, 2019 -
Hospital-acquired conditions fell 13% since 2014, CMS chief says
Administrator Seema Verma touted the data Tuesday, also hinting the agency is crafting value-based payment models for states and other insurers.
By Meg Bryant • Jan. 30, 2019 -
Narrow networks can effectively control health costs, report finds
But excluding hospitals in narrow plans may harm patients who live near those facilities, according to the American Economic Association paper.
By Les Masterson • Jan. 30, 2019 -
Insurer costs vary widely in ACA exchange: GAO report
The watchdog details the factors driving business decisions for carriers selling insurance plans on the ACA marketplace and attempts to explain how costs varied and how state policies affected participation.
By Samantha Liss • Jan. 30, 2019 -
Amgen's migraine lead faces early test in CVS decision
CVS lists migraine drugs from Teva and Eli Lilly as preferred over Amgen and Novartis' Aimovig, though analysts say the effect of this formulary change will likely be modest.
By Ned Pagliarulo • Jan. 30, 2019 -
Anthem accelerates launch of PBM IngenioRx
The insurer now expects earnings to be greater than $19 per share in 2019, company executives said as they issued year-end and fourth quarter results.
By Samantha Liss • Jan. 30, 2019 -
California hospital revenue, profitability rose under ACA, Medicaid expansion
Expansion replaced nearly all county-run safety net programs in the state, according to a new National Bureau of Economic Research working paper.
By Meg Bryant • Jan. 29, 2019 -
CMS launches app showing Medicare beneficiaries what their plans cover
The app's Blue Button 2.0 functionality also lets people connect claims information to tools that "help them understand, use and share their health data," the agency said.
By Les Masterson • Jan. 29, 2019 -
Deep Dive
Industry braces as more lawmakers seek to ban surprise billing
"Pretty much everybody agrees that the consumer shouldn't be trapped in the middle of these conversations — that's the easy part," said Jack Hoadley, research professor emeritus at the Georgetown University Health Policy Center.
By Shannon Muchmore • Jan. 29, 2019 -
Focus on usability, interoperability to help reduce health IT burden, groups tell ONC
Stakeholders also urged ONC to consider artificial intelligence tools as a means of relieving hassles from EHR use.
By Meg Bryant • Jan. 29, 2019 -
CVS-Aetna to offer Apple Watch app for members
The Attain app will allow Aetna members to set personalized activity goals, participate in weekly challenges and earn rewards as they reach milestones.
By Samantha Liss • Jan. 29, 2019 -
Doctors less likely to accept Medicaid than other insurance
MACPAC found no difference in Medicaid acceptance between doctors in states that expanded the program under the ACA and those that didn't — except with OB-GYNs.
By Les Masterson • Jan. 28, 2019 -
JAMA study makes case for investing in primary care
People with primary care receive more high-value care, slightly more low-value care and report better healthcare experiences than those without primary care, according to a new study in JAMA Internal Medicine.
By Meg Bryant • Jan. 28, 2019 -
Aetna, Anthem pilot seeks blockchain potential in healthcare
The initiative — which includes Health Care Service Corporation, IBM and PNC Bank — hopes to leverage blockchain for claims processing and health information exchange, among other potential uses.
By Meg Bryant • Jan. 25, 2019 -
Fewer Americans see doctors in their office, CDC data show
Chronic conditions were the leading reason for physician office visits in 2016, followed by "new problems" and preventive care.
By Meg Bryant • Jan. 25, 2019 -
Medicaid advisory panel calls for phasing in DSH allotment reductions
The suggestions also include changes in how disproportionate share hospital spending is allocated, and are projected to save the government anywhere from $1 billion to $5 billion over the next decade.
By Rebecca Pifer Parduhn • Jan. 25, 2019 -
ACA exchanges showing stability after rocky years
More payers are offering Affordable Care Act plans and premium increases are relatively modest despite attempts from Washington to undermine the law, according to a report from the Urban Institute.
By Les Masterson • Jan. 25, 2019
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