Payer: Page 146
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Lawsuit alleges UnitedHealth concealed Medicare Advantage complaints
The payer is facing multiple other allegations of orchestrating overpayments in the Medicare Advantage program.
By Les Masterson • July 28, 2017 -
Uncompensated care funding cuts set to begin next year
The CMS issued a proposed rule on Thursday that would enact ACA-mandated reductions to state Medicaid disproportionate share hospital payments.
By Jeff Byers • July 28, 2017 -
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 repeal dealt major blow with failed early morning vote
Efforts to repeal the ACA aren't officially dead, but the latest setback raises further questions as to how or whether Republicans plan to proceed.
By Shannon Muchmore • July 28, 2017 -
Deep Dive
Don't let the name fool you, ACA 'skinny' repeal has major consequences
A scaled-down version of ACA repeal is the latest GOP healthcare proposal, but it may just be a vehicle for returning to earlier, more conservative legislation.
By Shannon Muchmore • July 27, 2017 -
Healthcare deal volume may be down, but megadeals and value rose in Q2
PwC Deal Insights found there were 10 megadeals in health services in the second quarter valued at a total of $43.3 billion.
By Les Masterson • July 26, 2017 -
Anthem posts positive Q2 earnings, suggests more ACA exits
The payer pointed to the uncertainty over cost-sharing reduction payments for the ACA market instability.
By Les Masterson • July 26, 2017 -
ACA growth helps Centene to strong Q2 numbers
Total revenues increased 10% compared to a year ago.
By Les Masterson • July 25, 2017 -
Failed BCRA vote shows tough road ahead for ACA repeal, replace
A procedural vote to continue discussion of Republican healthcare legislation passed on Tuesday afternoon.
By Shannon Muchmore • July 25, 2017 -
Molina to eliminate 1.4K jobs this year
Former CEO Dr. Mario Molina was dismissed in May.
By Jeff Byers • July 25, 2017 -
ER staffing companies can lead to increased surprise bills
A new National Bureau of Economic Research study found patients who visited in-network hospitals for emergency care received out-of-network physician care 22% of the time.
By Les Masterson • July 24, 2017 -
Parliamentarian review makes passing BCRA even harder
Provisions that cannot be passed through the budget reconciliation process include removing essential health benefits for state Medicaid plans and the defunding of Planned Parenthood.
By Shannon Muchmore • July 24, 2017 -
Centene to open health clinic in Missouri grocery store
The move is part of a broader trend of insurers getting into primary care.
By Meg Bryant • July 21, 2017 -
CMS wants more oversight over Medicare Advantage provider networks
The CMS found in January that 45% of MA provider directories had incorrect information.
By Les Masterson • July 21, 2017 -
CBO: Out-of-pocket health costs would skyrocket under revised BCRA
The newest CBO score doesn't change much of the political discussion currently, but it has some drastic illustrations of how high deductibles and general out-of-pocket spending could get.
By Shannon Muchmore • July 21, 2017 -
Payers see growth opportunities in Medicare Advantage
Humana plans to add 500 employees to handle MA applications during the open enrollment period.
By Les Masterson • July 20, 2017 -
CBO: ACA repeal would cause 32M to lose insurance by 2026
The latest analysis found average premiums in the nongroup market would increase by about 25% next year and nearly double by 2026.
By Shannon Muchmore • July 20, 2017 -
UnitedHealth announces strong Q2 numbers
The company’s Optum business saw its earnings increase 21% in the quarter.
By Les Masterson • July 18, 2017 -
Deep Dive
The BCRA is dead, but don't take your eye off Capitol Hill
The healthcare industry may have dodged a bullet, but this week’s legislative stumbles for the GOP don’t mean healthcare is off the table for Congress. Here's what to watch.
By Shannon Muchmore • July 18, 2017 -
Reducing hospital readmissions not associated with increased risk of death, study finds
The study looks at unintended consequences of CMS’ Hospital Readmissions Reduction Program.
By Meg Bryant • July 18, 2017 -
UPDATE: BCRA, repeal-and-delay plans both dead for now
The GOP won’t easily give up its best chance to repeal the ACA since the law was enacted, but options are dwindling.
By Shannon Muchmore • July 18, 2017 -
Lawmakers prod CMS to collect Meaningful Use overpayments
A recent HHS Inspector General’s investigation found CMS paid more than $700 million to healthcare professionals who did not meet the program's requirements.
By Meg Bryant • July 18, 2017 -
Deep Dive
Despite federal delays, bundled payments will be entrenched in US healthcare
Bundled payment models serve as an entry to value-based care because of the relatively low risk providers take on. While these programs aren't yet proven to be successful, there is enough positive data to support participation.
By Les Masterson • July 17, 2017 -
Kaiser Permanente names 13 to new medical school board
The Kaiser Permanente School of Medicine will admit its first students in 2019.
By Meg Bryant • July 14, 2017 -
American Family Care gets $1B investment in urgent care locations
American Family Care is the largest operator of urgent care centers, and the new deal is expected to add another 300 locations.
By Les Masterson • July 14, 2017 -
Oscar and Humana set sights on small business insurance market
The partnership comes as both companies are looking for new business avenues outside the ACA exchanges, which are struggling with instability amid political uncertainties.
By Meg Bryant • July 13, 2017
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