Payer: Page 145
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AHIP spokesperson says MA rate increase 'doesn't move the needle'
The Medicare Advantage market is growing and payers are taking notice, but not just because of a recent rate increase from CMS.
By Luke Gale • April 7, 2017 -
IBM names blockchain adoption principles
Blockchain’s value increases as its network grows, the company says.
By Meg Bryant • April 6, 2017 -
Explore the Trendlineâž”
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 -
Deep Dive
Cleveland Clinic CEO warns against consequences of ACA replacement
Toby Cosgrove said hospital consolidation is an important step in the transition toward promoting value over volume.
By Shannon Muchmore • April 6, 2017 -
Wellmark to exit Iowa individual insurance exchanges
After the announcement from Wellmark, only two payers are contemplating insurance exchanges in many parts of the Hawkeye State.
By Luke Gale • April 5, 2017 -
UnitedHealth can sue CMS over Medicare Advantage overpayment rule
The rule allows the CMS to treat overpayments like False Claims Act violations.
By Meg Bryant • April 4, 2017 -
Senate bill would expand Medicare-covered telehealth options
Telehealth models would be tested for cost, effectiveness and quality of care before being covered for all Medicare patients.
By Meg Bryant • April 4, 2017 -
Medicare Advantage payment rates to increase by 0.45%
The rate increase is slightly more than the 0.25% the CMS suggested in February.
By Shannon Muchmore • April 4, 2017 -
Deep Dive
What payers want to know before they commit to exchanges
Payers would like answers on premium subsidies, risk corridor payments and the individual mandate before they can make decisions on insurance exchanges for the 2018 coverage year.
By Luke Gale • April 1, 2017 -
Bill would balance payments to ambulatory surgery centers
Under the measure, payment rates for ambulatory surgery centers would be updated using the same measure as hospital outpatient departments.
By Meg Bryant • March 31, 2017 -
Survey: Half of U.S. docs favor single-payer health system
A new LinkedIn survey found 64% of doctors have measures to ensure payment by patients with high-deductible health plans.
By Meg Bryant • March 31, 2017 -
House to proceed with legal challenge against ACA subsidies
Republicans have argued insurance subsidies should be funded through the appropriation process.
By Luke Gale • March 31, 2017 -
Report: Anthem could be nearing decision to pull out of ACA exchanges
CEO Joseph Swedish previously indicated that the payer's participation for the 2018 coverage year would depend on any changes made by the presidential administration to the federal healthcare law.
By Luke Gale • March 31, 2017 -
AHA: New CMS hospital payment rule not accurate reflection of care costs
The American Hospital Association has requested the CMS withdraw the rule, stating that the changes would result in payments that don't accurately reflect the actual costs to a hospital for treating the uninsured or underinsured.
By Shannon Muchmore • March 31, 2017 -
AMR teams up with Lyft for nonemergency patient rides
Hospitals and caregivers can access Lyft via AMR’s One Call service.
By Meg Bryant • March 30, 2017 -
Deep Dive
How hospitals feel about AHCA's death, future with ACA
An analyst at Strategy&, a member of the PwC network of firms, lets on there is a sense of relief among providers but many questions remain with the future of healthcare reform.
By Jeff Byers • March 30, 2017 -
Price's testimony at HHS budget hearing hints at revival of ACA repeal bill
The HHS secretary said he would enforce the ACA as long as it continues to be the "law of the land."
By Ana Mulero • March 30, 2017 -
Health plans a blight on profitable performance at Banner Health
Provider-sponsored health plans have become more popular in recent years, but they are generally not contributing to profitability.
By Luke Gale • March 28, 2017 -
DOJ joins Medicare Advantage fraud lawsuit against UnitedHealth
Involvement in the False Claims Act lawsuits against the payer indicates the agency will pursue fraud as aggressively under President Donald Trump as it had under President Barack Obama.
By Luke Gale • March 28, 2017 -
Trump picks former Anthem lobbyist as next head of DOJ antitrust division
Makan Delrahim's nomination has raised additional concerns with the review process of the proposed $54 billion Anthem-Cigna merger under the new presidential administration.
By Ana Mulero • March 28, 2017 -
UPMC offers emergency telehealth services statewide
The average wait time for an AnywhereCare video visit is six-and-a-half minutes.
By Meg Bryant • March 28, 2017 -
Anthem stands firm over cost savings argument in appeals court
If Anthem-Cigna is finalized, the combined company would cut fees to care providers, the health insurer's attorney acknowledged.
By Ana Mulero • March 27, 2017 -
Hospitals delaying projects amid ACA repeal uncertainty
Hospitals can’t predict how many patients will be insured in a post-ACA world or what type of health insurance coverage they will have.
By Meg Bryant • March 24, 2017 -
ACA repeal bill dies in House, GOP says it will move on
It’s a stunning turnabout for Republicans who have campaigned for seven years on repealing and replacing the ACA and a major blow for President Donald Trump and House Speaker Paul Ryan.
By Shannon Muchmore • March 24, 2017 -
Survey: Most patients aren't budgeting for out-of-pocket healthcare costs
High-deductible health plans are on the rise, but most patients would be pressed to cover associated out-of-pocket costs if required, according to a survey from Amino and Ipsos.
By Luke Gale • March 21, 2017 -
Deep Dive
Why the GOP's proposals to cap Medicaid funding won't work
Limiting the amount of funding made to state’s Medicaid programs to generate federal savings could cost billions of dollars and strip millions of Americans from their health insurance coverage.
By Ana Mulero • March 21, 2017
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