Payer: Page 119
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UPMC's net income hits $1.3B in 2017
Operating revenue grew to $16 billion, fueled by strong clinical demand and growth in UPMC’s insurance business.
By Meg Bryant • March 2, 2018 -
Clover Health sees losses cut, revenue climb in 2017
The Alphabet-backed startup had revenue of $267 million, an increase from $184 million in 2016.
By Meg Bryant • March 2, 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 -
Hartford HealthCare, Tufts partner on new insurance company
The organizations will focus on enrolling seniors in Medicare Advantage plans.
By Meg Bryant • March 2, 2018 -
Medicaid can be key to tackling social determinants of health
Researchers said adding optional Medicaid benefits, integrating data systems and incorporating social determinants in screening and care delivery can help reduce disparities.
By Les Masterson • March 2, 2018 -
DOJ chucks most of UnitedHealth false billing lawsuit
The move comes two weeks after a California federal judge threw out charges the insurer falsely attested the data were inaccurate.
By Meg Bryant • Feb. 28, 2018 -
Network directory errors remain an issue, AMA report finds
Previously, CMS has spoken out about errors in provider directories of Medicare Advantage plans.
By Les Masterson • Feb. 28, 2018 -
Association health plans will up ACA market premiums, Avalere says
AHPs are a key part of the Trump administration’s plan to sidestep Affordable Care Act regulations.
By Les Masterson • Feb. 28, 2018 -
20 states suing to invalidate ACA
The Republican attorneys general are arguing that with the individual mandate penalty zeroed out, it can't be enforced and the law is unconstitutional.
By Shannon Muchmore • Feb. 28, 2018 -
CVS, Aetna unscathed through congressional hearing
The AMA is asking Congress to "closely scrutinize the pending merger deal" on worries it would reduce competition among PBMs, local health insurance markets and local retail pharmacy markets.
By David Lim • Feb. 28, 2018 -
Alphabet's Verily seeks collaboration with health insurers
CNBC reported the life sciences arm of Google is interested in assisting payers with population health management.
By Les Masterson • Feb. 28, 2018 -
Clinicians seek more time in risk-free ACO track
Of the 561 accountable care organizations currently in the Medicare Shared Savings Program, 82% are still in Track 1.
By Meg Bryant • Feb. 27, 2018 -
CMS study to shed light on MIPS burden
The study could lead to changes in data capture and reporting, the agency said.
By Meg Bryant • Feb. 27, 2018 -
Kentucky Medicaid to penalize patients for unneeded ED visits
The move is part of a larger plan to reshape Medicaid in Kentucky, most notably requiring able-bodied beneficiaries to work to be eligible for coverage.
By Les Masterson • Feb. 27, 2018 -
Elizabeth Regan/Healthcare Dive
PhRMA pitches value-based care, skeptics raise flags
The link between outcomes-based contracts and copayments is hard to discern.
By Randi Hernandez • Feb. 27, 2018 -
6.4M more will be uninsured next year, Urban Institute says
Trump administration policies and the end of the individual mandate will result in fewer people insured, leading to higher premiums for ACA exchange plans, according to the report.
By Les Masterson • Feb. 27, 2018 -
Deep Dive
CVS, Aetna go to Congress to defend proposed merger
CVS is expected to argue that the merger will allow for better-integrated patient care by enabling pharmacists, equipped with both prescription and medical information, to play a bigger role between physician visits.
By David Lim • Feb. 27, 2018 -
Moody's: Aggressive insurer growth strategies threaten nonprofit hospitals
The embrace of value-based payment models is shifting more patients to cheaper outpatient settings, the ratings agency said.
By Meg Bryant • Feb. 23, 2018 -
Anthem rescinds same day service cut, AMA says
It's a win for the AMA and other providers that protested the E/M cut planned for 14 states. Anthem had already reduced the cut from 50% and delayed the onset for two months.
By Shannon Muchmore • Feb. 23, 2018 -
High deductible plan use jumps since 2010, now at 43%
The National Center for Health Statistics also said the percentage of uninsured Americans in 2017 remained about the same as the previous year.
By Les Masterson • Feb. 23, 2018 -
Flawed evaluation of Medicaid demonstrations limits policy impact, GAO says
The government watchdog looked at state evaluations of Medicaid demonstrations in three states and found shortcomings in each of them.
By Meg Bryant • Feb. 23, 2018 -
Deep Dive
Trump short-term health plan may spur more ACA exits
The impact of the individual mandate repeal and higher premiums could inflate a shift out of ACA plans.
By David Lim • Feb. 23, 2018 -
Community health center patients more likely to cite housing struggles, JAMA reports
People who can’t rely on steady housing will likely have difficulties staying on top of their health, adhering to medication and making appointments.
By Les Masterson • Feb. 22, 2018 -
Anthem to limit anesthesiologists in latest cost-saving move
Critics of the policy say it will force cataract surgery patients to pay for the service themselves or face higher risks.
By Les Masterson • Feb. 21, 2018 -
Express Scripts joins Walgreens Boots to cut biosimilar costs
The pharmacy benefit manager is expanding its agreement with the drug store giant to simplify the supply chain for specialty pharmaceuticals.
By Lisa LaMotta • Feb. 21, 2018 -
Deep Dive
Anthem's cost-cutting drive riles providers
The payer said the E/M payment cut is one way to reduce costs for its members and employer clients, but critics say the change may require patients to return for another doctor visit.
By Les Masterson • Feb. 21, 2018
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