Payer: Page 110
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Providers protest Texas Blue Cross Blue Shield restrictions
Austin-area pediatric specialists have accused Blue Cross and Blue Shield of Texas Medicaid plans of failing to pay for certain services.
By Meg Bryant • Aug. 1, 2018 -
Molina beats expectations with $202M net income for Q2
The payer came off strong in its quarterly earnings report after last year's tumultuous changes.
By Rebecca Pifer • Aug. 1, 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 -
Unsubsidized coverage drops but individual market still stable
A Kaiser Family Foundation report found that about 2 million people dumped individual coverage over the past year, mostly middle-class Americans without subsidies to help control premiums.
By Les Masterson • Aug. 1, 2018 -
CMS pitches covering cardiac catheterization at surgical centers
Jefferies analysts expect the agency will eventually add coverage for knee replacements at ambulatory surgical centers.
By Susan Kelly • Aug. 1, 2018 -
Humana Q2 earnings driven by Medicare Advantage growth
At the same time, the payer lost Medicare prescription drug and Medicaid members over the past year.
By Les Masterson • Aug. 1, 2018 -
Provider consolidation outpacing payer in most of US, study shows
Nearly 90% of metropolitan statistical areas have highly- or super-concentrated provider markets, according to The Commonwealth Fund.
By Meg Bryant • Aug. 1, 2018 -
CMS delay on 2019 MSSP applications leaves ACOs in limbo
The holdup is likely tied to a proposed rule that has been stuck at the Office of Management and Budget since early May.
By Meg Bryant • July 31, 2018 -
Less than half of Americans worry about personal health data security
In contrast, nearly 70% of adults surveyed said they were extremely or very concerned about the security of their financial data.
By Meg Bryant • July 31, 2018 -
Patients often choose higher-cost locations for MRIs, study finds
Referring physicians have more influence over a patient's decision than out-of-pocket costs, according to the National Bureau of Economic Research report.
By Les Masterson • July 31, 2018 -
Centene, Ascension joining forces for Medicare Advantage plan
Though there are few specifics about the plan, the companies said it would be a preferred model for the systems and affiliates in multiple markets.
By Les Masterson • July 31, 2018 -
Harvard Pilgrim expands project to help members find cost-effective plans
The payer will work with MyHealthMath to use information from a one-on-one phone call to help members choose the best plan.
By Les Masterson • July 30, 2018 -
States sue Trump administration over AHP expansion
Critics fear that by tempting people with lower-cost offerings, AHPs and catastrophic plans could cause millions to flee the ACA exchanges.
By Les Masterson • July 30, 2018 -
Walgreens rolls out digital marketplace with 17 well-known providers
The platform lists prices for services ranging from lab tests to telehealth consults. Advocate and New York-Presbyterian are among those taking part.
By Meg Bryant • July 27, 2018 -
Despite higher medical spending, older Americans have less debt, study finds
The average size of medical debt dropped by nearly 40% between the ages of 27 and 64, according to a new Health Affairs study.
By Meg Bryant • July 27, 2018 -
IBM, Anthem extend digital infrastructure contract
A key part of the partnership is IBM providing flexibility for Anthem's infrastructure, including using predictability to find potential back-end problems.
By Les Masterson • July 27, 2018 -
Deep Dive
Some patients fight back against surprise medical bills
"People that come to us are often quite distraught," says Akshay Gupta, co-founder of CoPatient, a firm that helps patients resolve their medical bills.
By Meg Bryant • July 25, 2018 -
Anthem sees 23% net growth, eyes Medicare, Medicaid options
The payer's revenue was hurt by its pull-back from the ACA exchanges.
By Les Masterson • July 25, 2018 -
Anthem, Samsung, American Well announce telehealth collaboration
Using a Samsung Galaxy device, consumers can consult with experts in a variety of subspecialties. The updated app also includes fitness training, maternity advice and sleep tracking.
By Meg Bryant • July 24, 2018 -
Gender equity in healthcare still has a way to go, report finds
Only 5% of women in healthcare believe parity in the workplace will happen in the next five years.
By Meg Bryant • July 24, 2018 -
Centene revenue up on ACA plan growth
The payer reported a 19% increase in year-over-year Q2 revenues to $14.2 billion.
By Les Masterson • July 24, 2018 -
Liability immunity reduces defensive medicine without hurting outcomes, paper says
When doctors are immune from liability they order fewer tests and procedures, reducing inpatient spending by 5%, according to the study from the National Bureau of Economic Research.
By Meg Bryant • July 24, 2018 -
UnitedHealth sees growing interest in ACOs
The nation's largest private payer expects ACOs will continue to grow over the next year as employers look for ways to cut costs and improve quality.
By Les Masterson • July 23, 2018 -
State individual mandates would boost coverage, curb premiums
The Commonwealth Fund reported there would be more than 7 million fewer uninsured people in 2022 if all states implemented individual mandates.
By Les Masterson • July 23, 2018 -
Getty / Edited by Healthcare Dive
UnitedHealth eyes Tenet's healthcare management business, WSJ reports
Tenet is still weighing whether to sell Conifer, which accounted for 8% of the company's revenue in 2017.
By Meg Bryant • July 20, 2018 -
Controversial Anthem ER policy under fire in lawmaker's report
Under its policy of denying payment for ER visits later determined not to be emergencies, the insurer denied 5.8% of claims in three states across a six-month stretch in 2017. On appeal, a majority of those were later overturned.
By Rebecca Pifer • July 20, 2018
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