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

Explore the Trendline➔

Payer/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

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

In reversal, GSK to restart limited payments to doctors

It's a step back from a 2013 pledge that made the British drugmaker an outlier among its industry peers.

By Ned Pagliarulo • Oct. 3, 2018

Pair of doctor surveys find burnout fears, pessimism about value-based contracting

More than half of respondents to a Doctors Company survey said EHRs are negatively affecting the physician-patient relationship, hurting productivity and damaging workflow.

By Les Masterson • Oct. 3, 2018

GAO: rural hospital closures increasing, South hardest hit

States with Medicaid expansion were less likely to have rural hospital closures than states that did not broaden the program, according to the analysis.

By Meg Bryant • Oct. 2, 2018

Medicare Advantage premiums expected to drop again

CMS predicted 36% of Medicare beneficiaries will have an MA plan in 2019, and more than 90% of them will have 10 or more plans to choose from.

By Les Masterson • Oct. 1, 2018

Three-fourths of Medicare Advantage denials overturned on appeal, OIG finds

The investigation revealed "widespread and persistent" problems with Medicare Advantage organization denial decisions and letters.

By Meg Bryant • Sept. 28, 2018

Supreme Court to hear DSH payments case

An appellate court found HHS violated the Medicare Act by altering the formula for disproportionate share hospital payments without public notice and comment.

By Meg Bryant • Sept. 28, 2018

Hospitals prepare for uncompensated care payment change

The move is meant to even the playing field for hospitals and create more transparency.

By Les Masterson • Sept. 28, 2018

Employer-based health insurance offerings increase for first time in decade

Healthcare costs, however, remain a major concern for small businesses, according to the Employee Benefit Research Institute.

By Les Masterson • Sept. 28, 2018

Bipartisan opioid bill has IMD exclusion, expands MAT

The legislation, which also opens up non-addictive pain management alternatives and increases enforcement of illegal fentanyl, is expected to pass both houses as early as next month.

By Les Masterson • Sept. 27, 2018

Aetna sells Medicare Part D business to WellCare subsidiary

The deal is meant to grease the wheels for approval of the payer's pending $69 billion acquisition by CVS.

By Samantha Liss • Sept. 27, 2018

Safety-net hospitals get break on FY19 readmission penalties, analysis finds

Some penalties are being cut by half or more, and 65 safety-net facilities that were penalized last year will see no dock at all this year, according to a data review by Kaiser Health News.

By Les Masterson • Sept. 27, 2018

AHA study finds hospital outpatient departments see sicker, poorer Medicare patients than independent docs

The research comes as CMS is proposing site neutral payment for hospital and nonhospital outpatient clinics.

By Meg Bryant • Sept. 26, 2018

UnitedHealthcare threatens to drop Envision providers

Envision, which employs more than 23,000 clinicians, said it is preparing to continue to serve patients and hospitals "without disruption regardless of the contract status with any payer."

By Les Masterson • Sept. 26, 2018

Maryland reinsurance program credited for premium decreases

Before CMS approved the program, the state's four individual health plans requested an average increase of 30.2%, but they have now put forward rates with an average decrease of 13.2%.

By Les Masterson • Sept. 26, 2018

Medicaid expansion particularly helped rural areas, small towns, report finds

"Overall, the experience of Medicaid expansion states demonstrates the great opportunity for states that have not yet expanded Medicaid," Jack Hoadley, lead author of the report, said in a statement.

By Les Masterson • Sept. 26, 2018

New York regulator warns CVS-Aetna merger could raise prices, reduce consumer choice

The state's top financial watchdog said the pharmacy chain's PBM would have an incentive to give the largest drug discounts to Aetna members, causing "anti-competitive effects" in the rest of the market.

By Samantha Liss • Sept. 26, 2018

CVS execs promote proposed Aetna merger as cost saver

The deal would allow the pharmacy chain to have more touch points with the payer's members, particularly those with chronic diseases, company leaders said.

By Samantha Liss • Sept. 25, 2018

Reports explore connection between race, ethnicity, socioeconomics, health

The study by U.S. News and the Aetna Foundation found that the strongest predictors of community health performance were factors like high homicide rates, low birth weight and access to healthy, affordable food.

By Les Masterson • Sept. 25, 2018

Major healthcare groups question Medicare ACO proposal

CMS would like more providers to take on risk, but practices have been slow to transition.

By Les Masterson • Sept. 24, 2018

Medicaid spending increase expected to exceed GDP growth over next decade

A new HHS Office of the Actuary report projected an average annual rate increase of 5.7% until 2026.

By Les Masterson • Sept. 24, 2018