Partners, Harvard Pilgrim weighing potential merger

The largest health system in Massachusetts and one of the state's biggest health plans confirmed they have been discussing potential deals for months.

By Meg Bryant • May 8, 2018

CMS rejects Kansas plan to create lifetime Medicaid limits

Meanwhile, New Hampshire became the fourth state to get approved for work requirements and Utah moved a step closer to getting an expansion of the program on the ballot this fall.

By Les Masterson • May 8, 2018

Explore the Trendline➔

Payer/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

Nearly 90% of companies pay employees to participate in wellness programs

Originally focused on issues like weight loss and smoking, today’s well-being programs are tackling stress management, social connectedness and more.

By Meg Bryant • May 4, 2018

Most ACOs would leave MSSP if forced into risk, survey finds

Accountable care organizations are leery of the amount of risk they could face in the program next year such as unpredictable changes by CMS.

By Meg Bryant • May 4, 2018

Cigna sees Q1 membership, revenue growth thanks to commercial market

The payer also raised its 2018 outlook and said it is poised for growth in the Medicare Advantage market.

By Tony Abraham • May 3, 2018

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

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

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