Payer: Page 117
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Millennials more likely to use walk-in clinics, telemedicine, survey shows
Young people are shopping around more for providers and health plans, and are using online tools to support decision-making.
By Meg Bryant • March 23, 2018 -
EHR revamp from CMS lacks concrete path to implementation, Joe Biden says
The former VP’s suggestions include automatically sharing data with patients and alerting patients when they qualify for a clinical trial.
By Meg Bryant • March 22, 2018 -
Explore the Trendlineâž”
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 -
ACA plan premium changes varied widely
Large premium hikes were connected to marketplace uncertainty, policy changes and payers dropping out of the exchanges, according to the Urban Institute.
By Les Masterson • March 22, 2018 -
Highmark Health's provider arm has best ever operating performance year
The company said its ACA plans were also profitable for the first time in 2017.
By Les Masterson • March 21, 2018 -
White House report targets health insurer profitability
The Council of Economic Advisers report argues many insurance companies' net profit margins have returned to pre-ACA levels on the backs of taxpayers.
By David Lim • March 21, 2018 -
HHS makes case against hospitals' 340B suit in new filing
"Setting aside the final rule for 2018 would direct payments away from these other services while creating administrative havoc in the OPPS system," HHS argued in a court filing this week.
By David Lim • March 21, 2018 -
Urgent care claims skyrocket; ER claims pale in contrast
A new FAIR Health analysis of more than 25 billion privately billed healthcare claims found large differences in growth depending on the place of service.
By Les Masterson • March 21, 2018 -
Blues plans made money in individual market last year
Payers still face an uncertain 2018 and 2019 in the ACA exchanges.
By Les Masterson • March 20, 2018 -
Maryland's all-payer model saved Medicare millions in first 3 years
A review of the state program found that it's on track to meet CMS-imposed targets for savings and patient safety.
By Les Masterson • March 19, 2018 -
CMS finalizes coverage of DNA sequencing for cancer patients
The agency will cover similar tests approved by the FDA.
By Jeff Byers • March 19, 2018 -
Trump to pitch national PDMP to fight opioid crisis
The president will visit New Hampshire to announce a slate of proposals, including calling for legislation to allow Medicaid to reimburse residential treatment at facilities with more than 16 beds.
By David Lim • March 19, 2018 -
Alex Wong via Getty Images
CMS plans MACRA changes to ease burden
CMS is expected to add more alternative payment models and is hoping to automatically receive quality data from EHRs rather than physicians reporting the data.
By Les Masterson • March 19, 2018 -
AMA survey says prior authorizations hurting clinical outcomes
Nearly one-third of physicians said they needed to wait at least three business days for a prior authorization decision, and doctors say the payer requests are rising.
By Les Masterson • March 19, 2018 -
Docs more likely to prescribe opioids after pharma pay, study finds
Opioid manufacturers paid physicians more than $43 million over a two-year period, according to CareDash.
By Meg Bryant • March 16, 2018 -
Reducing inappropriate joint replacements could save billions
Lack of patient education, variation in device prices and use of inpatient versus outpatient settings help fuel unnecessary costs around these procedures, according to a viewpoint in JAMA.
By Meg Bryant • March 16, 2018 -
ACA stabilization bills may become part of spending package
The Congressional Budget Office said resurrecting CSR payments could reduce premiums and increase the number of insured Americans.
By Les Masterson • March 16, 2018 -
CMS star ratings biased towards specialty hospitals, analysis suggests
Specialty hospitals reported fewer measures than major teaching hospitals, and frequently omitted mortality data.
By Meg Bryant • March 16, 2018 -
340B accountability under fire at Senate panel
The hearing comes as drugmakers point fingers at hospitals and other players involved in the drug pricing system.
By David Lim • March 15, 2018 -
BCBS joins with Lyft, CVS and Walgreens in new pop health effort
The payer is looking to address "transportation and pharmacy deserts" in test markets.
By Les Masterson • March 15, 2018 -
Hospitals acquired 5K physician practices in 1-year period
The report concluded that physicians struggle to maintain independent practices because payer policies "increasingly favor integrated health systems."
By Shannon Muchmore • March 14, 2018 -
Centene partnering with PBM RxAdvance
The announcement comes as other payers, such as Cigna and Aetna, are looking to make major moves in the PBM space.
By Les Masterson • March 14, 2018 -
AHIP's CEO Tavenner to retire
The organization's chief operating officer, Matt Eyles, will be next to lead the lobby group.
By David Lim • March 14, 2018 -
Deep Dive
More employers go direct to providers, sidestepping payers
A recent survey found that only 6% of employers contract directly with providers now, but 22% are considering it for 2019.
By Les Masterson • March 14, 2018 -
HDHPs can be more cost-effective for consumers, report says
A new National Bureau of Economic Research working paper looked at how much people could save over a year by going with high-deductible health plans.
By Les Masterson • March 14, 2018 -
CVS Health, Aetna shareholders vote to approve merger
The deal, which was scrutinized by Congress in late February, is emblematic of a quickly consolidating healthcare sector.
By David Lim • March 13, 2018
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