Payer: Page 129
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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 -
JAMA: Admin costs vary by type of visit
The researchers said their findings could be used to inform policies that reduce administrative costs.
By Les Masterson • Feb. 20, 2018 -
UPDATE: CMS seeks expansion of short-term plans to sidestep ACA
HHS acknowledges that the exodus of young and healthy exchange members could contribute to rising premiums within the ACA exchange markets.
By Jeff Byers , David Lim • Feb. 20, 2018 -
Healthcare industry 'ripe for disruption,' S&P Global warns
Segments considered most vulnerable include medical and lab supplies, healthcare e-commerce and retail pharmacies.
By Meg Bryant • Feb. 16, 2018 -
Anthem makes exceptions to controversial ER policy
In the six states where Anthem denies ER claims it later deems unnecessary, patients who receive treatment on a weekend or receive certain services, for example, are now exempt.
By Shannon Muchmore • Feb. 16, 2018 -
CMS to watch and wait on Idaho Blue Cross's ACA-skirting plans
HHS Secretary Alex Azar told lawmakers the department would look at the health plans and measure them against ACA requirements once it receives a waiver request from the insurer.
By David Lim • Feb. 16, 2018 -
Georgia hospitals sue Anthem over ER, imaging policies
Anthem will shortly stop paying for imaging in hospitals and for emergency department care that it later deems not an emergency.
By Les Masterson • Feb. 15, 2018 -
Healthcare spending to reach 19.7% of GDP within a decade
Hospital care spending growth is expected to increase 5.5% on average between 2017 and 2026, the report finds.
By Jeff Byers • Feb. 14, 2018 -
Reducing healthcare costs not one-size-fits-all, report finds
The Network for Regional Healthcare Improvement analyzed healthcare costs for five states and found huge differences in terms of costs and drivers.
By Les Masterson • Feb. 14, 2018 -
Montgomery County Planning Commission
Aetna prior authorization probed by 2 states
A former medical director said he didn't review patient medical records when deciding on authorization, but instead relied on Aetna nurses' guidance.
By Les Masterson • Feb. 14, 2018 -
Survey: 80% of payers taking steps to address social determinants of health
Healthcare leaders now see high deductible health plans as a negative incentive with little effect in changing consumer behavior.
By Meg Bryant • Feb. 14, 2018 -
Most healthcare execs say value-based programs led to positive financial results
A Healthcare Financial Management Association survey also said commercial payers haven’t rolled out value-based programs as quickly as expected.
By Les Masterson • Feb. 14, 2018 -
Hospitals performed small amount of cost-shifting, study finds
Recent research found that hospitals negotiated 1.5% higher average private payer reimbursements to offset cuts from public payers.
By Les Masterson • Feb. 13, 2018 -
Molina posts $269M Q4 loss after turbulent year
Molina Healthcare went through major changes in 2017, including removing its CEO-president and CFO.
By Les Masterson • Feb. 13, 2018 -
Kaiser 2017 revenue up 11%, buoyed by Group Health buy
Total operating revenue was $72.2 billion in 2017.
By Jeff Byers • Feb. 12, 2018 -
Alex Wong via Getty Images
Trump budget slashes Medicaid, targets 340B
The proposal is more a political document than anything else, but HHS Secretary Alex Azar said it addresses priorities including a push toward paying for value.
By Shannon Muchmore , David Lim • Feb. 12, 2018 -
More oversight for 340B needed, White House council says
The Council of Economic Advisers suggested creating an independent agency to oversee the prescription payment program.
By Les Masterson • Feb. 12, 2018 -
GAO: Medicare cost-sharing update would involve trade-offs
Capping beneficiary out-of-pocket costs could reduce demand for supplemental insurance, the agency said.
By Meg Bryant • Feb. 9, 2018 -
ACA enrollment fell overall, but ticked up in state-run exchanges
The figures don't tell the whole story, however. The 2018 numbers were expected to fall well below previous signups after the Trump administration spent the past year trying to dismantle the ACA.
By Les Masterson • Feb. 9, 2018
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