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

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

Labor, administrative costs drive US healthcare spending far beyond other nations

The report found the U.S. pays more for healthcare than other high-income countries, but has the lowest percentage of insured people, the lowest life expectancy and the highest infant mortality rate.

By Les Masterson • March 13, 2018

Cigna launches Amazon Alexa skill to increase health literacy

The move comes months after Mayo Clinic launched a health-related voice control that aimed to assist people with first aid advice.

By David Lim • March 13, 2018

Drug spending growth to come solely from specialty meds, report says

Developed markets will shell out more than $300 billion for the often complex, expensive treatments this year, according to new estimates from IQVIA.

By Jacob Bell • March 13, 2018

Restoring CSR funds with no reforms may do more harm

The individual market endured an end to cost-sharing reduction payments, but reviving them without more changes could threaten stability, a new report said.  

By Les Masterson • March 12, 2018

GOP actions may spur huge ACA premium hikes

Premiums could skyrocket by more than 90% in some states over the next three years, according to a report by Covered California.

By Les Masterson • March 12, 2018

Bundled payments favor certain hospitals, analysis shows

Hospitals that achieved savings in the Comprehensive Care for Joint Replacement program tended to be larger, nonprofit and high-volume.

By Meg Bryant • March 9, 2018

Too soon to tell if health-in-all-policies approach improves equity, study finds

The connection between health-in-all-policies and health equity tends to be strategic and issue-dependent, according to a Health Affairs report.

By Meg Bryant • March 9, 2018

Medicare Advantage risk-adjustment proposal causes alarm

The American Hospital Association and other groups are concerned about the plan to use more patient encounter data when calculating risk scores.

By Les Masterson • March 9, 2018

CMS denies Idaho bid to sell plans not compliant with ACA

Agency head Seema Verma said that despite the denial, the state could meaningfully implement many of the same goals legally through short-term, limited-duration plans. 

By David Lim • March 9, 2018

VisitPay, J.P. Morgan partner in new patient financing initiative

Patients are paying a greater portion of their healthcare costs, which is making providers look to third-party specialists to offer financial solutions. 

By Les Masterson • March 8, 2018

Cigna acquiring Express Scripts in $67B deal

It's the latest in vertical integration across the industry, after regulators blocked horizontal tie-ups in recent years.

By Shannon Muchmore • March 8, 2018

UnitedHealth Group plans more scrutiny of ED claims

The payer will review emergency claims with the most serious conditions and reduce or deny any incorrect claims it finds.

By Les Masterson • March 8, 2018

Roadmap to reduce disparities needed in value-based care

A Health Affairs paper recommends tying health equity to payment incentives. 

By Meg Bryant • March 8, 2018

Gottlieb takes aim at payers, pharmas for blocking biosimilars

The FDA chief lambasted PBMs, insurers and branded drugmakers for allegedly blocking market entry of the copycat biologics.

By Lisa LaMotta , David Lim • March 8, 2018

Out-of-pocket healthcare costs up 11% in 2017

Highest out-of-pocket cost estimates were for orthopedics, plastic surgery, urology and neurology.  

By Les Masterson • March 7, 2018

Insurers, hospitals slam Trump admin's association health plan proposal

America’s Health Insurance Plans argued the proposal could increase the risk of fraud and insolvency for consumers.

By David Lim • March 7, 2018

Report underscores value in value-based care programs

UnitedHealthcare said ACOs serving employer-sponsored plan beneficiaries outperformed non-ACOs on 87% of quality measures tracked in 2017.

By Meg Bryant • March 6, 2018

CMS floats $30M for QPP measures development

Areas for measure development include safety, care coordination, population health and prevention.

By Meg Bryant • March 6, 2018

State efforts to impose individual mandate going nowhere

Six states and Washington, D.C., have all proposed measures to bring back the individual mandate penalty for health insurance, but so far no legislature has done so.  

By Les Masterson • March 6, 2018

HIMSS18: CMS chief touts EHR, PHR overhaul

Seema Verma said the agency is planning a "complete overhaul" of meaningful use standards for hospitals, but provided few details.

By Kim Dixon • March 6, 2018