Payer: Page 132
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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 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/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 -
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 -
Deep Dive
3 reasons evidence-based policy is hard
Academics and policymakers gave advice on the challenges to making evidence-based policy at a recent healthcare conference.
By Shannon Muchmore • Feb. 9, 2018 -
Smorgasbord of health items in massive 2-year budget deal
The agreement staving off an extended government shutdown includes a delay to Disproportionate Share Hospital payment cuts, a repeal of the ACA's Independent Payment Advisory Board and more funding to fight the opioid crisis.
By David Lim • Feb. 9, 2018 -
Judge rejects whistleblower lawsuit involving Epic billing software
The case was brought by a former compliance review specialist at WakeMed Health.
By Meg Bryant • Feb. 8, 2018 -
CVS easily beats Q4 forecast, sees Aetna deal on track
CEO Larry Merlo said on an earnings call "nothing that has surfaced" on the Aetna merger bid has come as a surprise, and he still expects the deal to close in the second half of this year.
By David Lim • Feb. 8, 2018 -
Kansas considers telehealth parity bill
The bill, introduced last month, has strong support from providers and insurers in the state.
By Meg Bryant • Feb. 7, 2018 -
Management organizations can play key role in ACOs
A Health Affairs report found partnerships helped providers in ACOs with data, administrative, educational and care coordination services.
By Les Masterson • Feb. 7, 2018 -
Express Scripts: Plan drug spending rose at slowest rate in 24 years
The PBM says its efforts to rein in rising drug costs have helped the plans it administers secure hundreds of millions in savings last year.
By Ned Pagliarulo • Feb. 7, 2018 -
Deep Dive
Intermountain, Geisinger shift focus to patients in revenue cycle
Patients are now a major payer, and providers need to adapt their strategies.
By Les Masterson • Feb. 7, 2018 -
Humana Q4 earnings a mixed bag
After increasing individual Medicare Advantage membership by only 1% in 2017, the insurer gained more than 3 million members in January.
By Les Masterson • Feb. 7, 2018 -
Rideshares fail to reduce patient no-show rates, study shows
A number of hospitals and health systems have partnered with Uber and Lyft in an attempt to help people get to appointments.
By Meg Bryant • Feb. 6, 2018 -
GAO says assisted living facilities need better oversight by state Medicaid
The agency found 26 state Medicaid agencies could not report the number of critical incidents that occurred in assisted living facilities.
By Les Masterson • Feb. 6, 2018 -
Expanding ACA plans drove Centene to 8% revenue growth
In announcing its Q4 earnings, the payer raised its guidance for 2018 after a successful open enrollment period in the ACA exchanges.
By Les Masterson • Feb. 6, 2018 -
AHIP: 71% satisfied with employer healthcare, 66% say cost unreasonable
“Without a vibrant employer-sponsored marketplace the overall healthcare delivery system would not be able to deliver the services that it is delivering today," said Cigna CEO David Cordani.
By David Lim • Feb. 6, 2018 -
Slavitt leads bipartisan heavy hitters in health access effort
Newly-formed United States of Care, under former CMS chief Andy Slavitt's leadership, is partnering with Penn LDI to ultimately expand health coverage to all Americans.
By Jeff Byers • Feb. 6, 2018 -
Deep Dive
How to make population health pop: What experts say
Barriers to successful pop health initiatives include quantifying and monetizing health information that may not lend itself to such analysis and getting organizations with different priorities to work together.
By Shannon Muchmore • Feb. 6, 2018 -
Varied uptake in e-consults at New England VA facilities: Health Affairs
The researchers looked at use of anesthesiology e-consults for preoperative evaluation.
By Meg Bryant • Feb. 6, 2018 -
Highest healthcare spenders vary each year
The top 5% of healthcare spenders in 2015 accounted for 53% of spending, a new Health Care Cost Institute analysis found.
By Les Masterson • Feb. 5, 2018 -
Medicaid work requirements bring uncertainty to hospital bottom lines, Fitch warns
Kentucky has already received a Medicaid waiver that allows it to implement work requirements, and seven more states could follow shortly.
By Meg Bryant • Feb. 2, 2018 -
UPDATE: Indiana Medicaid work waiver approved
The Trump administration is giving states more flexibility in running Medicaid, but critics say some changes restrict access to care for the most needy.
By Les Masterson • Feb. 2, 2018 -
DOJ seeks more info on proposed CVS, Aetna merger
CVS did not say what information DOJ is seeking, but the request is not unexpected.
By Shannon Muchmore • Feb. 2, 2018 -
Medicare Advantage plans to see 1.84% rate bump
CMS is also proposing opioid prescribing limits starting in 2019 for Part D plans to help stem the opioid crisis.
By David Lim • Feb. 2, 2018 -
Changes from DC could mean a difficult year ahead for hospitals
Issues facing hospitals this year include Medicaid DSH cuts, a possible return of mandatory bundling initiatives and CMS potentially moving hip replacement procedures to outpatient.
By Les Masterson • Feb. 1, 2018