Academic medical centers lag behind other facilities for cost, quality

Despite improvements on some metrics, AMCs still face more Medicare value-based program penalties, according to a Navigant report.

By Les Masterson • Aug. 9, 2018

CVS rejects pharma claim that rebates push up drug prices

Responding to charges that PBMs pocket much of drug rebates, the pharmacy giant said it retains only 2% of the price concessions from drugmakers. 

By Ned Pagliarulo • Aug. 9, 2018

CVS rolls out virtual care offering in 9 states

The program leverages Teladoc's technology platform and is available through the CVS app.

By Meg Bryant • Aug. 9, 2018

ACOs using medical home physicians save money, yield higher quality, report finds

"ACOs and patient-centered medical homes are cut out of the same cloth," Robert Mechanic, executive director of the Institute for Accountable Care, said about the research.

By Rebecca Pifer Parduhn • Aug. 8, 2018

Small, medium payers show growing interest in provider-sponsored plans

A new white paper looked at that payer marketplace niche, which has seen significant turnover in the past five years.

By Les Masterson • Aug. 8, 2018

Small company employees with high-deductible plans get less help with out-of-pocket costs

More than three-fourths of HDHP members in small companies don't have an employer-funded account, according to a study from researchers at the Agency for Healthcare Research and Quality.

By Les Masterson • Aug. 8, 2018

Humana sues drugmakers alleging generic price-fixing scheme

The insurance giant's civil suit, which lists 16 drugs and nearly 30 drugmakers, closely tracks ongoing federal and state criminal investigations.

By Andrew Dunn • Aug. 8, 2018

5 takeaways from payer Q2 earnings reports

Health insurers found success in Medicare, Medicaid and even the ACA exchanges.

By Les Masterson • Aug. 8, 2018

Cigna claps back at Icahn in defense of Express Scripts acquisition

In a lengthy letter to shareholders, Cigna claims activist investor Carl Icahn's disapproval of its pending deal with Express Scripts is "misguided and short-sighted." Shareholders will vote on the deal Aug. 24.

By Tony Abraham • Aug. 8, 2018

CMS to allow step therapy in MA plans in bid to boost price competition

Dan Best, CMS senior advisor for drug pricing reform, told reporters the policy could save 15-20% of the $12 billion annual spend by MA plans on oft-pricey Part B drugs. Not all analysts buy that estimate.

By David Lim • Aug. 8, 2018

Market concentration tied to higher premiums in ACA markets, study finds

Premiums in marketplaces with monopolist insurers were 50% higher than in markets with more than two insurers, according to a Health Affairs report.

By Meg Bryant • Aug. 7, 2018

GM contracting directly with Henry Ford Health System

The companies say the new plan is forecasted to save employees between $300 and $900 per year in healthcare costs without raising deductibles.

By Rebecca Pifer Parduhn • Aug. 7, 2018

Icahn blasts Cigna-Express Scripts deal as among 'worst acquisitions in corporate history'

The activist investor warned that PBMs are under a political microscope too risky for Cigna investors, also citing risks from Amazon. Shareholders vote on the deal Aug. 24.

By David Lim • Aug. 7, 2018

CMS' Verma stands firm on 2015 EHR deadline, move to open APIs

Meanwhile, the coalition Health IT Now sent a letter to ONC chiding the government for failing to implement information blocking provisions of the 21st Century Cures Act.

By Meg Bryant • Aug. 7, 2018

Kaiser Permanente's Q2 revenue growth driven by higher premiums, new members

The Oakland-based health system also saw a 47% decrease in operating revenue that it blamed on a new accounting standard.

By Les Masterson • Aug. 7, 2018

More employers look toward value-based insurance plans

After years of implementing cost-sharing policies like the use of high-deductible plans, businesses are looking for new avenues to reduce costs and improve health.

By Les Masterson • Aug. 6, 2018

Healthcare M&A remains hot, but value fell in Q2

Despite the activity, there was only one industry megadeal in the quarter — KKR's $10 billion buy of Envision.

By Les Masterson • Aug. 3, 2018

Opioid prescriptions aren't decreasing, study finds

The results come despite myriad attempts from lawmakers, providers and payers to curb opioid use, including prescribing and dosage restrictions.

By Les Masterson • Aug. 2, 2018

Anthem, doc.ai to test blockchain-enabled AI to predict allergies

Doc.ai's end-to-end platform includes trial recruitment, engagement, data collection and predictive models.

By Meg Bryant • Aug. 2, 2018

Express Scripts income up, defends PBM model

The largest U.S. PBM touted 9.4% growth over the same quarter last year amid uncertainty around the future of the industry and the firm's pending merger with Cigna.

By Rebecca Pifer Parduhn • Aug. 2, 2018

Aetna sees slight revenue bump, membership drop

A day earlier, California's insurance commissioner came out against the payer's pending $69 billion deal with CVS.

By Les Masterson • Aug. 2, 2018

Cigna's commercial market success continues in Q2

The payer reported earnings that included a total revenue increase of 10% to $11.5 billion compared to the same quarter in 2017, beating Wall Street expectations.

By Tony Abraham • Aug. 2, 2018

Final rule expands short-term health plans to 12 months

The plans can now have a maximum duration of a year, but can be renewed for a total of three years. HHS expects 600,000 people to enroll next year with as many as 6 million by 2022.

By Tony Abraham • Aug. 1, 2018

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 Parduhn • Aug. 1, 2018