Payer: Page 136
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Altarum launches value-based reimbursement contracting company
Payformance Solutions aims to bridge the gap in provider-payer negotiations.
By Meg Bryant • 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 Meg Bryant • Nov. 16, 2017 -
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 Shannon Muchmore • Nov. 15, 2017 -
Individual mandate repeal included in latest tax bill draft
CBO has said eliminating the ACA's individual mandate would result in 14 million people losing coverage by 2025 and premium increases of about 20%.
By Shannon Muchmore • Nov. 15, 2017 -
Study raises concerns about mortality risks in readmissions penalty program
Recent research found that while heart failure patients were less likely to be readmitted since the implementation of the Hospital Readmission Reductions Program, their mortality rate increased.
By Meg Bryant • Nov. 14, 2017 -
AMA opposes weakening ACA's essential health benefits
The organization argues changing the requirements would hurt patients by stripping protections from high out-of-pocket costs.
By Les Masterson • Nov. 14, 2017 -
Deep Dive
How will instability in the ACA exchanges affect healthcare in 2018?
“Insurance markets work best when there’s stability and when everyone has a pretty good sense of how the market is going to operate. Sadly, we’re not there right now,” says Ken Wood, senior vice president of health plan development at Evolent Health.
By Les Masterson • Nov. 13, 2017 -
Report shines light on ACO successes, strategies
The CMS recently found that 11 of 18 Next Generation ACOs earned savings in 2016.
By Les Masterson • Nov. 13, 2017 -
Trump nominates former pharma exec Azar to head HHS
Alex Azar served as deputy secretary for HHS from 2005 to 2007 under President George W. Bush and until January of this year served as Eli Lilly’s president.
By Shannon Muchmore • Nov. 13, 2017 -
Most states have their own value-based payment programs, report says
Much attention recently has focused on the CMS’ value-based program adjustments, but Change Healthcare found states aren't necessarily waiting for federal direction.
By Les Masterson • Nov. 13, 2017 -
Altarum: 43 states get failing marks on healthcare price transparency
Healthcare spending inched up just 1.1% in September, according to a separate Altarum report.
By Meg Bryant • Nov. 10, 2017 -
Digital health could be saving $7B today, report says
Study authors looked at published research in five areas — diabetes prevention, diabetes care, asthma, cardiac rehabilitation and pulmonary rehabilitation.
By Meg Bryant • Nov. 9, 2017 -
Deep Dive
How will expanding catastrophic health plans affect providers?
A recent presidential executive order to expand the use of safety net coverage could drive down care utilization, but might also promote more patient engagement among providers and payers.
By Les Masterson • Nov. 9, 2017 -
Hospital-employed physicians create more Medicare costs
Services at hospital-employed physicians' offices increased Medicare costs for four services by $3.1 billion between 2012 and 2015, according to a new study from the Physicians Advocacy Institute.
By Les Masterson • Nov. 9, 2017 -
Price increases, population growth drive majority of rising healthcare spending
Healthcare spending rose from $1.2 trillion to $2.1 trillion between 1996 and 2013, according to new research published in JAMA.
By Les Masterson • Nov. 8, 2017 -
Humana cuts 2,700 jobs, profits drop in Q3
The payer has been working to shed costs since its failed merger with Aetna earlier this year
By Les Masterson • Nov. 8, 2017 -
Maine voters approve Medicaid expansion
The referendum passed easily and will expand the program to 80,000 additional residents.
By Shannon Muchmore • Nov. 8, 2017 -
Kaiser Permanente sees double-digit growth in Q3
Operating revenue for the period grew 11.5% to $18.3 billion compared with a year ago.
By Meg Bryant • Nov. 7, 2017 -
Health Affairs shares emerging lessons for ACO implementation
“In addition to designing policy reforms effectively, success requires providers to develop new patient-focused competencies,” the authors wrote.
By Les Masterson • Nov. 7, 2017 -
CMS signals more state flexibility with Medicaid
Administrator Seema Verma said the agency may allow work requirements for Medicaid eligibility.
By Les Masterson • Nov. 7, 2017 -
Report: Trump eyes executive order to cripple individual mandate
The president is reportedly waiting to see whether repealing the mandate becomes part of the tax bill on Capitol Hill.
By Les Masterson • Nov. 7, 2017 -
Humana suing to recover risk-corridor payments
The Louisville-based payer is seeking $611 million for payments it did not receive between 2014 and 2016.
By Les Masterson • Nov. 6, 2017 -
Deep Dive
The healthcare of tomorrow will move away from hospitals
Healthcare professionals gathered in Washington, D.C. last week for the annual U.S. News & World Report conference, where discussions focused on social determinants of health and how telemedicine enables patients to receive treatment in their homes.
By Jeff Byers , Shannon Muchmore • Nov. 6, 2017
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