Payer: Page 123
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Deep Dive
Virtual care moves toward the frontline of provider-patient relationships
Kaiser Permanente and UnitedHealthcare are among those using telehealth programs in place of primary care visits and quick patient consultations.
By Les Masterson • May 3, 2018 -
Humana credits TRICARE contract in 18.7% Q1 membership growth
The payer also raised its guidance, citing strong Medicare Advantage numbers.
By David Lim • May 2, 2018 -
Re-admissions window for hospital penalties should be cut, study suggests
Re-admissions that occur in the first week after a patient is discharged are more preventable than those occurring later, according to the Annals of Internal Medicine paper.
By Meg Bryant • May 1, 2018 -
Montgomery County Planning Commission
Aetna adds nearly 250K Medicare Advantage members in Q1
The payer posted profits of $1.2 billion in Q1 2018 compared to a loss of $381 million during the same period last year.
By David Lim • May 1, 2018 -
VCs look to palliative, long-term care plays
"Technology is nice but it's the cherry, not the ice cream," Lisa Suennen, senior managing director for healthcare investing at GE Ventures, said at Health Datapalooza.
By Jeff Byers • April 30, 2018 -
Humana targets inpatient admissions in new value-based program
The Hospital Incentive Program will reward providers for improvements in quality metrics.
By Meg Bryant • April 27, 2018 -
Florida awards lucrative 5-year Medicaid contracts
Forty plans placed bids, and major payers receiving contracts included UnitedHealth, Aetna and Humana.
By Tony Abraham • April 26, 2018 -
Medicare Plan Finder needs usability, transparency updates, report says
The National Council on Aging and the Clear Choices Campaign said the consumer tool should include more information on out-of-pocket costs and cut back on jargon.
By Tony Abraham • April 26, 2018 -
Deep Dive
Value-based pay a factor pushing docs to hospital work
The trend may raise costs, though, and there are signs it may be slowing.
By Les Masterson • April 25, 2018 -
CMS mulling direct provider contracting models
The concept grew out of an earlier request seeking guidance on a "new direction" for the Center for Medicare and Medicaid Innovation to promote patient-centered care and test market-driven reforms.
By Meg Bryant • April 24, 2018 -
Report finds most short-term plans don't cover maternity, substance misuse care
The expansion of short-term plans could have an adverse affect on the ACA-compliant individual market, according to the Kaiser Family Foundation.
By Tony Abraham • April 24, 2018 -
CMS pushes hospitals to post prices online
A sweeping 1,800-page proposed rule also would eliminate 25 quality measures across five programs with an aim to ease administrative burden and improve EHR interoperability.
By Jeff Byers , David Lim , Tony Abraham • Updated April 25, 2018 -
Centene ACA exchange membership spiked 35% in past year
The insurer posted better-than-expected earnings off of increased membership and lower Medicaid medical costs despite an intense flu season.
By David Lim • April 24, 2018 -
Humana, private equity firms to acquire hospice operator Curo
The same trio of companies announced in December they would acquire Kindred Healthcare in a $4.1 billion deal.
By Jeff Byers • April 24, 2018 -
Court allows class-action CSR payment lawsuit
The Department of Justice may appeal the ruling, which could ultimately result in billions of dollars in subsidies to payers offering plans in the ACA marketplace.
By Les Masterson • April 23, 2018 -
Managed care group looking at new MA plan benefits
A new CMS rule paves the way for plans to offer benefits not directly labeled as healthcare, such as ride-hailing services like Uber and Lyft that can help patients get to appointments.
By Meg Bryant • April 23, 2018 -
Walmart, Emory Healthcare working together on new ACO
Walmart has been at the forefront of a trend that sees employers contracting directly with providers in hopes of improving care while also reducing costs.
By Les Masterson • April 23, 2018 -
Payer trade groups slam short-term health plan proposal
The insurance lobbies argued that other policy mechanisms would be more effective at improving the individual health insurance market.
By David Lim • Updated April 24, 2018 -
Comcast, Independence Health team up on consumer-focused platform
The companies did not provide details about the new platform or say when it would launch, but the collaboration comes as providers and payers are focusing on value-based care models.
By Meg Bryant • April 20, 2018 -
Medicare spending on track to hit $1.2T in 2028, CBO says
Medicare outlays are expected to account for a third of all healthcare spending by the end of the decade, up from half currently, according to the report.
By Meg Bryant • April 19, 2018 -
Humana announces maternity bundled model for low- and mid-risk pregnancies
The new initiative is the payer's second specialty care payment model. A total joint replacement program is now available at about 40 orthopedic practices in 13 states.
By Meg Bryant • April 19, 2018 -
Pushing 'value,' Harvard Pilgrim tests outcomes deals
An agreement with AstraZeneca for the pharma's lung drug Symbicort is the ninth value-based contract publicly announced by the regional insurer.
By Ned Pagliarulo • April 19, 2018 -
Potential Medicare APM overlap an increasing concern
Competing payment models in the same area "may have far-reaching impact on provider incentives and behavior," the authors of a recent Health Affairs blog post said.
By Les Masterson • April 19, 2018 -
Illinois stops Medicaid enrollment to state's BCBS
The state sanctioned the payer’s Medicaid managed care plan after it reportedly didn't meet patient access guidelines.
By Les Masterson • April 19, 2018 -
Healthcare megadeals may have major long-term impact, Moody's says
Payer vertical integration could put more pressure on hospital volumes and margins, according to a new report.
By Les Masterson • April 18, 2018
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