Payer: Page 131
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A proposal to bolster ACA exchanges: Look to Medicare Advantage
The Urban Institute suggests five Medicare Advantage-inspired policies to stabilize the ACA market.
By Les Masterson • Jan. 31, 2018 -
Elizabeth Regan/Healthcare Dive
Deep DivePayers wade into real-world evidence, but tread lightly
Insurers and pharmacy benefit managers are wary about the quality of data underlying real-world evidence.
By David Lim • Jan. 31, 2018 -
Deep Dive
How Amazon, JPM, Berkshire could disrupt healthcare (or not)
News of three corporate giants forming an independent healthcare company "proves every business is a healthcare business," said David Vivero, CEO of the digital health startup Amino.
By Shannon Muchmore, Daphne Howland & Jeff Byers • Jan. 31, 2018 -
Anthem sees strong Q4, Medicare Advantage and PBM gains
The major Blues plan reported revenue growth in the fourth quarter of 2017, as well as membership gains for the year.
By Les Masterson • Jan. 31, 2018 -
State of the Union: 4 things Trump said on healthcare
Most of the healthcare ideas the president put forward have little chance of being enacted this year or lack funding to be effective.
By David Lim • Jan. 31, 2018 -
Court sets speedy 340B lawsuit schedule, siding with AHA
"We will continue to pursue our legislative and legal strategies to reverse these cuts, and expect to prevail in holding the agency accountable for overstepping its authority," Melinda Hatton, general counsel for the American Hospital Association, told Healthcare Dive.
By David Lim • Jan. 31, 2018 -
Medicare out-of-pocket costs seen rising to half of senior income
Older people in poor health, women and lower-income Americans are paying higher percentages of their per capita income on out-of-pocket Medicare costs.
By Les Masterson • Jan. 30, 2018 -
Amazon, JPM, Berkshire form new company to tackle health costs
The corporate giants gave few details about the new venture, but said the initial focus will be technology solutions to provide their stateside employees with high-quality, low-cost healthcare.
By Shannon Muchmore • Jan. 30, 2018 -
Montgomery County Planning Commission
Aetna posts strong Q4 profits, awaiting CVS Health merger
Aetna's net income of $244 million represents a 76% increase compared to the $139 million of profit posted during Q4 2016.
By David Lim • Jan. 30, 2018 -
Medicare Advantage membership grows almost 8%
The market is still dominated by a handful of payers and online provider directory errors remain a problem for MA.
By Les Masterson • Jan. 30, 2018 -
Deep Dive
Healthcare earnings this week: A primer
HCA, Aetna and athenahealth are among the notable players to report fourth quarter earnings.
By Jeff Byers • Jan. 29, 2018 -
Most hospitals will see Part B revenue increase despite 340B cut
The findings from Avalere come as hospitals challenge the 340B drug payment cut in court.
By David Lim • Jan. 29, 2018 -
CMS cost measure makes some Medicare Advantage plans pricier
The authors of a new Health Affairs analysis suggest limiting benchmark cost data to Medicare beneficiaries enrolled in both Part A and Part B.
By Meg Bryant • Jan. 26, 2018 -
Alex Wong via Getty Images
HHS touts regulatory rollbacks under Trump's first year
A 37-page report highlights priorities for the Trump administration, most of which have sharply divided the industry.
By Shannon Muchmore • Jan. 26, 2018 -
Medicaid could play key role in addressing social factors in healthcare
Many Medicaid programs collect data for social determinants of health, but not often in an organized way, according to a report from the National Qualify Forum.
By Les Masterson • Jan. 26, 2018 -
Healthcare data breaches up but fewer records at risk
More than a third of all data breaches last year were due to insider error or wrongdoing, according to a report from Protenus and DataBreaches.net.
By Meg Bryant • Jan. 25, 2018 -
Blue Cross of North Carolina opposes Carolinas-UNC merger
In a letter to the two health systems, BCBS CEO Dr. Patrick Conway said the deal would increase patient costs.
By Shannon Muchmore • Jan. 25, 2018 -
Pent-up needs may fuel Medicaid expansion costs: Avalere
In other Medicaid news, a group of Kentucky residents is suing HHS over the recent work requirement waiver.
By Les Masterson • Jan. 24, 2018 -
ACA helped reduce out-of-pocket costs: JAMA
Many low-income Americans, however, still face high out-of-pocket costs.
By Les Masterson • Jan. 24, 2018 -
CMS, VA to share data to prevent healthcare fraud
The partnership is the latest in federal agency steps to increase healthcare fraud and misuse prevention efforts.
By Jeff Byers • Jan. 24, 2018 -
Deep Dive
Providers make efforts, but cuts to low-value care elusive
Healthcare stakeholders know they should cut low-value services, but there are multiple obstacles to overcome.
By Les Masterson • Jan. 24, 2018 -
New York proposes Medicaid payment cuts to payers with large reserves
Gov. Andrew Cuomo is also suggesting a 14% tax on for-profit payers and requesting New York get "a cut of the proceeds when nonprofit insurers convert to for-profit companies."
By Les Masterson • Jan. 23, 2018 -
Medicaid buy-in could expand choices, lower premiums for a few states
The Urban Institute analyzed a buy-in proposal backed by Democrats eyeing a 2020 run.
By Les Masterson • Jan. 23, 2018 -
CHIP renewed 6 years, ACA taxes delayed under spending pact
Congress will need to approve another spending bill by Feb. 8, and it may include additional healthcare measures.
By Les Masterson • Jan. 23, 2018 -
EHRs can nudge docs toward prescribing fewer opioids, study finds
The University of Pennsylvania School of Medicine created a default system that physicians could overrule to prescribe more tablets, but the report found fewer opioids prescribed above the default limit.
By Les Masterson • Jan. 22, 2018
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