Payer: Page 104
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Immigration rule change could force millions off Medicaid, report warns
The Trump administration is proposing a change to "public charge" policies that could also lead to higher costs for providers via uncompensated care and more ER visits, according to the Kaiser Family Foundation.
By Les Masterson • Oct. 15, 2018 -
States requiring hospitals provide more info on 340B drugs
Most states don't track 340B drug payments after rebates, but gaining that information could ultimately result in a change to reimbursement amounts.
By Les Masterson • Oct. 15, 2018 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Grassley urges FTC to investigate hospital-payer contracts
The Senate Judiciary chairman is concerned that anticompetitive contracts could limit access to affordable care.
By Meg Bryant • Oct. 12, 2018 -
Average ACA premiums will drop for first time in 2019
Payers put through huge premium increases over the past two years, meaning next year's rates are likely a market correction.
By Les Masterson • Oct. 12, 2018 -
Deep Dive
Long-term care hospitals: Overpaid or underappreciated?
"The costs associated with operating a long-term care hospital are more closely aligned with short-term acute care hospitals, but less expensive," says Susan Maupin, president of The Advisory Group.
By Meg Bryant • Oct. 12, 2018 -
Montgomery County Planning Commission
'Nowhere to hide' for rivals after blockbuster CVS-Aetna deal
The nearly $70 billion merger poses threats to providers as its scale and access to care aims to shift the healthcare dynamic in favor of consumers, BDO's David Friend told Healthcare Dive.
By Samantha Liss • Oct. 11, 2018 -
CMS touts more highly-ranked MA prescription plans next year
More than 36% of Medicare beneficiaries are expected to have Medicare Advantage plans in 2019.
By Les Masterson • Oct. 11, 2018 -
CMS bid to overhaul E/M codes leaves few happy
With its proposed changes to payments and documentation for office visits, the agency is effectively forcing providers to reckon with a longstanding, oft-disputed problem.
By Tony Abraham • Oct. 10, 2018 -
Texas fines Humana for lack of in-network anesthesiologists
The state insurance commissioner said no Humana members will pay extra because of the network issue. The payer has agreed to a corrective action plan.
By Samantha Liss • Oct. 10, 2018 -
Arkansas Medicaid work requirements beset by challenges, report finds
Most are unaware of the new rules or face major obstacles to complying, according to the Kaiser Family Foundation study.
By Rebecca Pifer • Oct. 10, 2018 -
Bruce Bennett via Getty Images
DOJ clears CVS-Aetna union
Approval of the $69 billion deal comes with a condition to sell Aetna's Medicare Part D business.
By Samantha Liss • Oct. 10, 2018 -
Mayo, Geisinger among 1,300 providers signing up for BPCI-A
CMS announced the participants for its latest bundled payment model, including 832 acute care hospitals and 715 physician group practices.
By Les Masterson • Oct. 10, 2018 -
Court awards $1.2M in missed CSR payments to Montana co-op
A judge last month ruled the government was statutorily obligated to make the payments and the obligation "was not vitiated by Congress's failure to appropriate funds for that purpose."
By Les Masterson • Oct. 9, 2018 -
Cerner EHR rollout continues at 4 more Defense Department sites
The project is moving forward despite criticism during its initial implementation. An April report concluded deployment is "neither operationally effective nor operationally suitable."
By Meg Bryant • Oct. 9, 2018 -
Remote patient monitoring cuts hospital admissions, ER visits, report finds
Heart disease and COPD are the most popular uses, but other less acute chronic conditions are starting to find traction with the technology, the industry and KLAS report found.
By Meg Bryant • Oct. 8, 2018 -
Health spending growth gap continues between public and private payers
The sector seems to be in a "post-recession, post-expanded coverage period of steady, moderate growth," according to a report from Altarum.
By Les Masterson • Oct. 8, 2018 -
More individual plans limit out-of-network care, report finds
Payers that still offer such coverage have shifted more costs to consumers, according to the Robert Wood Johnson Foundation. Narrow networks are less common in large employer plans.
By Les Masterson • Oct. 8, 2018 -
Payers find financial success in the ACA exchanges
Insurers have found footing after years of uncertainty, but risks remain.
By Les Masterson • Oct. 8, 2018 -
New plans in Iowa don't offer pre-existing condition protections
Meanwhile, a federal judge scheduled a hearing on short-term health plans for Oct. 26. The plaintiffs filed a motion in September arguing those plans will harm the health insurance industry.
By Les Masterson • Oct. 5, 2018 -
CVS, Aetna defend merger potential to Connecticut regulators
The $69 billion deal is considered to have a good chance for approval. Aetna agreed last week to sell its standalone Medicare Part D business to help clear antitrust hurdles.
By Samantha Liss • Oct. 5, 2018 -
Health insurance premium growth exceeds wage increases, inflation
Employer-based single coverage deductibles rose 212% on average over the past decade, according to a report from the Kaiser Family Foundation.
By Les Masterson • Oct. 4, 2018 -
Hospitals charge nonconventional payers more than health insurers, study finds
Automobile and workers' compensation insurers paid hospitals about 50% more than HMOs or PPOs for the same service, according to the report by Johns Hopkins University researchers.
By Meg Bryant • Oct. 3, 2018 -
Employer-based health insurance premiums, deductibles rise
A new State Health Access Data Assistance Center report found variations by state for premiums, deductibles and out-of-pocket costs.
By Les Masterson • Oct. 3, 2018 -
Competition in ACA exchanges has plummeted since 2016
Counties without at least three payers offering plans tended to be rural and had higher mortality rates. They were also more likely to be in states that did not expand Medicaid.
By Les Masterson • Oct. 3, 2018 -
Intermountain's Liljenquist on price transparency, insulin and having 3 brothers with diabetes
The man behind the push for a new drug venture talks about how he hopes the move will force transparency across the healthcare continuum.
By Samantha Liss • Oct. 3, 2018
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