Payer: Page 115
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Virginia on cusp of expanding Medicaid
The state Senate on Wednesday moved past the most significant hurdle to expand Medicaid to an additional 400,000 residents, a long-sought goal of Democrats using the powers under the Affordable Care Act.
By David Lim • Updated May 31, 2018 -
Readmission rates among BPCI episodes show room for improvement
Groups mulling participation in the Bundled Payment for Care Improvement Advanced model may find success in targeting certain high readmission rates, according to a new report from Avalere.
By Shannon Muchmore • May 30, 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 -
WellCare to acquire Meridian for $2.5B
The deal, expected to close by the end of the year, will boost WellCare's presence in the growing Medicare Advantage market.
By Tony Abraham • May 30, 2018 -
ACA health insurance tax would be delayed 2 years under bipartisan bill
Insurance companies say ending the tax would let them reduce premiums by 3%.
By Les Masterson • May 29, 2018 -
Medicaid expansion sees movement in Virginia, may get vote in Idaho
Virginia could become the next state to expand Medicaid, with the state legislature expected to vote in the coming days on a plan that would tax hospitals to fund the added coverage.
By Les Masterson • May 29, 2018 -
CMS plugs Medicare Advantage in beneficiary handbook draft
A version of next year's guide, which hasn't yet been published, also subtly encourages people in MA plans to request prior authorization for services and supplies.
By Meg Bryant • May 25, 2018 -
California to hospitals: 'Time's up' on unnecessary procedures
Covered California is threatening to oust hospitals with high C-section rates from participating health plans' provider networks.
By Meg Bryant • May 25, 2018 -
Integrating behavioral health, primary care can save money
A Colorado program saved more than $1 million by creating a risk-adjusted payment system for practices that had on-site behavioral health providers.
By Les Masterson • May 25, 2018 -
Comments criticize CMS plan to cut Medicaid care access monitoring
Healthcare officials said the change could especially hurt rural hospitals and force facilities to take lower rates without any recourse.
By Les Masterson • May 24, 2018 -
CMS primary care model slowed ED visits, but did not cover costs
A new study found no significant differences between participants in the Comprehensive Primary Care Initiative and comparison practices when examining spending growth.
By David Lim • May 24, 2018 -
Payers should rethink Medicare Advantage marketing, report suggests
Accenture Consulting said insurers risk millions in revenue by not taking into account how many people wait until after 65 to enroll in Medicare.
By Les Masterson • May 23, 2018 -
Trump pricing plan could lead to higher patient costs, Avalere suggests
The consultancy says a proposal to move drugs from Medicare Part B to Part D could end up costing cancer patients more out of pocket.
By Lisa LaMotta • May 23, 2018 -
Hospitals could save millions on hip, knee implants
Optimizing use of anesthesia and bone cement, along with streamlining workflow, could cut costs for the expensive procedures, a Premier report found.
By Les Masterson • May 23, 2018 -
Anthem to acquire palliative care provider Aspire Health
The deal is expected to close in the third quarter of this year. Terms were not disclosed.
By Jeff Byers • May 23, 2018 -
Sponsored by Studer Group
Breathing Room: 3 powerful ways to respond to today's financial squeeze
Learn 3 strategies from a healthcare CEO for responding to financial pressures.
May 23, 2018 -
California plan would provide Medicaid to undocumented adults
The plan could cost as much as $3 billion in 2018 and 2019.
By Les Masterson • May 22, 2018 -
CMS should extend prior authorization pilots, GAO says
The handful of Medicare prior authorization programs saved an estimated $1.1 billion to $1.9 billion through March 2017, according to a new report.
By Shannon Muchmore • May 22, 2018 -
Payers in ACA exchanges beginning to find success
A Kaiser Family Foundation review of data from the National Association of Insurance Commissioners found that payers' MLR and gross margins have improved significantly in the ACA marketplace over the past two years.
By Les Masterson • May 18, 2018 -
Alex Wong via Getty Images
CMS weighing National Coverage Decision for CAR-T
The agency is considering whether there is enough evidence to support national Medicare coverage of the pricey cancer therapies.
By Lisa LaMotta • May 18, 2018 -
Sharecare patient engagement platform picked up by BCBS Minnesota, Walmart
The Atlanta startup offers health risk assessments, symptom checking and targeted messaging to prompt healthy behaviors.
By Meg Bryant • May 17, 2018 -
Cigna, Express Scripts SEC filings reveal roadmap, backstory of $67B deal
If either terminates the merger, it may owe the other company a $1.6 billion termination fee.
By David Lim • May 17, 2018 -
GAO: Patients say fees for accessing medical records are excessive
The report also found that some patients aren't aware they can access their records, or that they can challenge providers who deny them.
By Meg Bryant • May 16, 2018 -
Oscar looking to expand to more state ACA exchanges
The payer reported a profit in the first quarter of this year and significantly improved its medical loss ratio.
By Les Masterson • May 16, 2018 -
CMS' Verma says no to Medicaid lifetime limits
The administrator said the agency is still closely working with states on other types of waivers.
By David Lim • May 16, 2018 -
VA finalizes rule easing virtual care delivery
The rule allows VA providers to offer telehealth services across state lines regardless of licensing and regulation requirements.
By Meg Bryant • May 15, 2018
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