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

Explore the Trendline➔

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

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

Providers go deeper with population health, weighing social factors

Healthcare organizations are waking up to the importance of social determinants of health, like housing and nutrition.

By Les Masterson • Jan. 22, 2018

Shareholder sues Aetna to block CVS deal

The lawsuit claims Aetna's SEC filing for a proposed agreement with CVS included “materially incomplete and misleading information."

By Les Masterson • Jan. 18, 2018

Pharma, payers clash over CMS Part D drug rebate plan

The drug, pharmacy benefit managers and insurance industries are squabbling over a CMS proposal to require Part D sponsors to pass on a percentage of rebates to consumers.

By David Lim • Jan. 18, 2018

Hospitals, payers and docs collaborate on prior authorization

Trade groups for major healthcare players say they share a "commitment to industry-wide improvements to prior authorization processes and patient-centered care."  

By Les Masterson • Jan. 17, 2018

Uninsured rate in 2017 had biggest increase in a decade

The rate increased in all demographic groups except for senior citizens, but went up most for young adults, blacks, Hispanics and low-income Americans.   

By Les Masterson • Jan. 17, 2018

CBO analyzes pricing disparities between physician services, Medicare

The agency compared the prices three major insurers paid for common services against Medicare's fee-for-service program. The difference is substantial.

By Tony Abraham • Jan. 16, 2018

UnitedHealth Group earnings up in Q4, hikes forecast due to tax bill

Jeff Alter, CEO of UnitedHealthcare Employer & Individual, pointed to the potential impacts of the ACA's health insurance tax, saying consumers will see much higher premiums if the tax is not delayed or repealed. 

By Jeff Byers , David Lim • Jan. 16, 2018

Kentucky first to try Medicaid work requirement

Allowing states to require work is one way the Trump administration is looking to reduce the size of Medicaid. 

By Les Masterson • Jan. 15, 2018

Trump admin's new bundle bid shows value-based care's staying power

Advocates of value-based payment reform breathed a sigh of relief last week when CMS announced a new bundled payment model.

By Shannon Muchmore • Jan. 12, 2018

FDA lays out digital health goals in 2018 strategic roadmap

The agency will continue to build out its Pre-Certification Pilot Program to help encourage the development of digital health tools.

By David Lim • Jan. 12, 2018

Worldwide ambulance market to reach $48.9B by 2025

Advanced life-support ambulance services are expected to dominate the market over the next eight years.

By Meg Bryant • Jan. 12, 2018

Lawsuit accuses Centene of misleading customers on narrow ACA plans

The allegations against Centene come as the Trump administration is moving toward narrower networks in ACA exchanges.

By Meg Bryant • Jan. 12, 2018

CMS goes all in on Medicaid work requirements

At least ten states are considering section 1115 Medicaid waivers that require enrollees to have a job, train for a job or participate in community activities like volunteer work.

By Shannon Muchmore • Jan. 11, 2018

ACOs flock to Medicare Shared Savings Program

Most of the ACOs in a risk-based contract chose Track 1+, which is the latest risk model.   

By Les Masterson • Jan. 11, 2018

CMS extends Maryland all-payer program for another year

Maryland is working with the agency on a larger proposal to include outpatient services.  

By Les Masterson • Jan. 10, 2018

Payers with ACA plans expected to have relatively strong year

Experts predict a fairly stable 2018 for the individual market, as long as Congress doesn't try another "repeal and replace" effort or make more moves that might destabilize the exchanges. 

By Les Masterson • Jan. 10, 2018

CMS launches new, voluntary bundled payment model

The Bundled Payments for Care Improvement Advanced program will be considered an advanced alternative payment model for the purposes of MACRA reporting.

By Shannon Muchmore • Jan. 10, 2018

Azar talks list prices, mandatory Medicare pilots

The nominee for HHS secretary identified high drug prices and shifting payment models to reward health outcomes as among his top priorities.

By David Lim • Jan. 9, 2018

Could narrow networks be the next big cost cutter?

Narrow provider networks can mean lower costs, but also less flexibility for members and likely lower patient satisfaction. 

By Les Masterson • Jan. 9, 2018

Health Affairs: Ending Medicaid expansion would cause rural hospitals to go under

Researchers found Medicaid expansion improved hospital finances and meant a substantially lower chance that hospitals — especially rural facilities — closed.

By Les Masterson • Jan. 9, 2018

GAO: CMS must improve state-reported data collection for Medicaid

“CMS has taken steps for the initial use of T-MSIS data, but does not have a plan or associated timeframes for using these data for oversight,” GAO said.

By Les Masterson • Jan. 9, 2018

Amino pitches new HSA amid growth in high deductibles

The company is betting that high deductibles and better education over HSAs will incite greater utilization.

By Jeff Byers • Jan. 8, 2018