Payer: Page 129


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    CVS Health to buy Aetna in $69B deal

    The deal would combine CVS's retail pharmacy services with Aetna's health insurance business, creating a healthcare giant with significant market power.

    By , Dec. 3, 2017
  • Senate passes tax bill that repeals individual mandate

    Lawmakers will now attempt to work out the differences between the Senate bill and a House version passed last month that preserves the mandate.

    By David Lim • Dec. 2, 2017
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    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
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    Cigna-HealthSpring, Lyft tout Medicare Advantage ride numbers

    Meanwhile, MedStar’s partnership with Uber, now in its second year, has lowered transportation costs to 60% of the cost of a cab ride, extending the reach of the nonemergency transport budget by 40%.

    By Dec. 1, 2017
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    Avalere: Nearly 75% of 2018 exchange plans have restrictive networks

    Average deductibles for silver plans will rise from $3,703 this year to $3,937 in 2018, according to the report.

    By Dec. 1, 2017
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    Family physicians warming to value-based payments, but barriers remain

    More than half of family physicians are now participating in value-based payment models, and some believe they lead to greater collaboration between primary care physicians and specialists.

    By Les Masterson • Nov. 30, 2017
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    Physician ratings drop when patient requests denied, study says

    The study suggests that improved communication between doctors and patients could help mitigate lower physician ratings, based on observational analysis.

    By Nov. 30, 2017
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    CMS finalizes hip fracture and cardiac bundled payment program cancellations

    The agency is also moving forward with proposed changes to reduce the mandatory geographic areas for the joint bundled program.  

    By Les Masterson • Nov. 30, 2017
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    Study raises questions over pay-for-performance program impacts

    The article "should be the final nail in the coffin of the current generation of P4P," an accompanying editorial stated.

    By Nov. 29, 2017
  • Care use, costs increase when doctors are connected to each other

    The JAMA study found that patients whose physicians' networks included more primary care physicians saw more primary care visits but fewer specialists and emergency visits.

    By Les Masterson • Nov. 29, 2017
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    UnitedHealth shares dip temporarily after projected earnings

    The company's Optum unit announced it is launching Optum Ventures, a $250 million fund to develop healthcare startups.  

    By Les Masterson • Nov. 29, 2017
  • Deep Dive

    5 payer trends to watch in 2018

    Expect insurers to accelerate programs and policies that cut costs and to push for value-based contracting as consumers demand more transparency in healthcare pricing.

    By Les Masterson • Nov. 28, 2017
  • Deep Dive

    How Anthem's new PBM will impact pharma

    David Henka, CEO of RxTE Health, sat down with BioPharma Dive to discuss the implications of a new pharmacy benefit manager entering the marketplace. 

    By Jacob Bell • Nov. 28, 2017
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    ACA enrollment up, but may not overcome shorter signup period

    Nearly 2.3 million Americans signed up for ACA plan coverage through Nov. 18, which is about 200,000 more compared to the first 26 days of open enrollment last year.

    By Les Masterson • Nov. 27, 2017
  • VA's Shulkin wants to boost use of private care

    The VA has been moving toward more consumer choice in healthcare for some time.

    By Nov. 22, 2017
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    Report: Supportive policies needed to advance connected health technologies

    Top priorities include reimbursement, remote patient monitoring and interoperability.

    By Nov. 22, 2017
  • States that run their own exchanges have lower uninsured rates

    States using the federal exchange have double the uninsured rate through the first six months of this year compared to states that have their own exchange, according to the CDC.

    By Les Masterson • Nov. 22, 2017
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    Optum gets caught up in Express Scripts, Anthem legal wranglings

    The case involves a pricing proposal that Optum gave Anthem after the payer requested the information.   

    By Les Masterson • Nov. 21, 2017
  • Medicare beneficiaries to see some cost increases next year

    Some Medicare Part B enrollees will see a premium increase in 2018. 

    By Les Masterson • Nov. 20, 2017
  • Deep Dive

    Why payers are flocking to the Medicare Advantage market

    The CMS predicts more than one-third of all Medicare enrollees will be in MA plans next year.

    By Les Masterson • Nov. 20, 2017
  • CMS proposes Medicare Advantage, drug rebate changes

    The number of plans available to individuals will increase from about 2,700 to more than 3,100, according to the agency.

    By , Ned Pagliarulo • Nov. 17, 2017
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    Altarum launches value-based reimbursement contracting company

    Payformance Solutions aims to bridge the gap in provider-payer negotiations.

    By Nov. 17, 2017
  • California fines Anthem $5M for systemic grievance system violations

    The state has fined the payer $11.66 million for grievance system violations since 2002.

    By Les Masterson • Nov. 17, 2017
  • Survey shows major leap in telemedicine use over past 3 years

    Most organizations are also looking to grow their programs — including overseas.

    By Nov. 16, 2017
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    Hospital revenue cycles improving, but denials are up

    A report from Advisory Board shows a median 350-bed hospital lost $3.5 million in increased denial write-offs from payers over the past four years.

    By Les Masterson • Nov. 16, 2017
  • Deep Dive

    What you need to know about the new nominee to lead HHS

    Alex Azar's previous stint at the agency is a plus in the eyes of many, but his more recent time as an executive for pharma giant Eli Lilly casts doubt on the Trump administration's promise to rein in drug prices.

    By Nov. 15, 2017