Payer: Page 137
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Anthem CEO to retire
Former United Healthcare CEO Gail K. Boudreaux will succeed Joseph Swedish as CEO and president.
By Jeff Byers • Nov. 6, 2017 -
Cigna profits up, fueled by strong enrollment
Revenues for the period were $10.4 billion, up 5% from a year ago.
By Meg Bryant • Nov. 3, 2017 -
CMS scrubs plan for home health groupings model
The agency wants more time to consider stakeholder concerns about access and case complexity.
By Meg Bryant • Nov. 3, 2017 -
Experts say bundled models can have major success, but participation is key
There is not at the moment much interest from Congress in promoting alternative payment models, however.
By Shannon Muchmore • Nov. 3, 2017 -
Providers added staff, upgraded facilities after ACA increased rate of insured
An Urban Institute survey found there are still significant unmet healthcare needs for behavioral health, adult dental and specialty services.
By Les Masterson • Nov. 2, 2017 -
CMS finalizes 340B drug program cut
In a final rule, the agency also removed total knee arthroplasty from the inpatient only list.
By Shannon Muchmore • Nov. 2, 2017 -
New guidance for MACRA reporting: Attestation against information blocking
Under the 21st Century Cures Act, providers and EHR vendors are barred from blocking information.
By Meg Bryant • Oct. 31, 2017 -
AMA survey shows how Medicaid expansion affected patient mix
The average share of Medicaid patients among all physicians was 16.9% last year.
By Meg Bryant • Oct. 31, 2017 -
Montgomery County Planning Commission
Aetna silent on possible CVS deal during Q3 disclosures
The payer said its net income skyrocketed 39% in the third quarter compared to a year ago.
By Les Masterson • Oct. 31, 2017 -
Proposed rule would let states decide essential health benefits
The administration’s latest attempt to chip away at the ACA would also allow states to determine medical loss ratio requirements.
By Les Masterson • Oct. 31, 2017 -
CMS approves Iowa Medicaid waiver ending retroactive coverage
Hospitals in the state have opposed the proposal, which they said will hurt them financially by increasing charity care costs.
By Les Masterson • Oct. 31, 2017 -
More healthcare spending going to alternative payment models
CMS Administrator Seema Verma on Monday announced an initiative focused on quality, a new direction for the Innovation Center and the need to cut regulations for providers.
By Les Masterson • Oct. 31, 2017 -
Specialist groups oppose MedPAC recommendation to end MIPS
The Alliance of Specialty Medicine represents more than 100,000 specialty physicians from 13 specialty and subspecialty societies.
By Les Masterson • Oct. 27, 2017 -
Trump declares opioids public health emergency but doesn't add funding
Industry groups and public health officials generally praised the declaration as a step in the right direction, but acknowledged that opioid misuse is a massive problem for the country that will require significant efforts — and resources — to overcome.
By Shannon Muchmore • Oct. 27, 2017 -
CVS reportedly in talks to buy Aetna
The Wall Street Journal reported a $66 billion deal is being discussed as CVS looks to bolster itself in preparation for Amazon's potential entry into the drug distribution business.
By Shannon Muchmore • Oct. 27, 2017 -
Anthem beats Q3 expectations as it pulls back ACA plan offerings
The payer's medical enrollment grew by 347,000 members compared to a year ago and totaled 40.3 million at the end of September.
By Les Masterson • Oct. 26, 2017 -
Judge declines to force continued payment of CSRs
As the legal battle over the cost-sharing reduction payments continues, a report from Avalere found premiums for silver level plans will increase by an average of 34% next year.
By Shannon Muchmore • Oct. 26, 2017 -
Choosing Wisely campaign not resonating with physicians
The ABIM Foundation created the program, which provides recommendations about low-value healthcare services to discuss with patients, in 2012.
By Les Masterson • Oct. 25, 2017 -
Deep Dive
The hospital divestiture trend is heating up, and not going away anytime soon
Healthcare financial experts agree the divestiture trend is only getting started as health systems look for ways to shed facilities in a tough environment for hospitals.
By Les Masterson • Oct. 25, 2017 -
Gallup: Uninsured rate climbs to 12.3% in Q3
The biggest drop in coverage was among people with self-pay plans.
By Meg Bryant • Oct. 24, 2017 -
New payers eye Medicare Advantage market
Devoted Health plans to start selling plans in 2019; Oscar Health Insurance is also showing interest in launching plans.
By Les Masterson • Oct. 24, 2017 -
AMA: Nearly 70% of payer markets 'highly concentrated'
The annual report found that 90% of markets have at least one insurer with a 30% or greater market share.
By Les Masterson • Oct. 24, 2017 -
Centene reports 9.7% revenue increase in Q3 amid ACA plan expansion
The St. Louis-based payer saw its membership grow by nearly 8% from the same time last year.
By Les Masterson • Oct. 24, 2017 -
States struggling to maintain CHIP without federal dollars
Lawmakers have still not reauthorized the program, and officials from six states and the District of Columbia fear they’ll run out of CHIP money by the end of the year.
By Les Masterson • Oct. 24, 2017 -
Congress continues to negotiate CSR funding
A bipartisan bill to restore the cost-sharing reduction payments has prospects but also many hurdles.
By Shannon Muchmore • Oct. 23, 2017
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