Payer: Page 148
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Optum, Merck announce project to test linking payments to drug effectiveness
The two companies plan to publicly share the results of the multi-year collaboration.
By Les Masterson • May 30, 2017 -
VA set to expand Epic MASS pilot
The agency has been under pressure to replace its outdated patient records system with one that is fully automated.
By Meg Bryant • May 26, 2017 -
California healthcare purchasers team up to tackle the US' $200B medical waste problem
Known as Smart Care California, the coalition is initially focused on reducing elective cesarean sections, opioid use and overtreatment for patients with lower back pain.
By Meg Bryant • May 25, 2017 -
Blues prep opposite plans for ACA exchanges in Mo., NC
Blue Cross NC plans an average 22.9% rate increase if CSRs are not paid, but could also still opt out of the ACA exchanges by the fall. Meanwhile, Blue KC will pull out of the market entirely.
By Les Masterson • May 25, 2017 -
CMS delays bundled payment expansion, again
The cardiac and joint bundled payment programs will now become effective on Jan. 1, 2018.
By Jeff Byers • May 24, 2017 -
California single-payer plan could cost $400B annually
The California Senate Committee on Appropriations said the plan still has uncertainties but would undoubtedly be "an unprecedented change in a large healthcare market."
By Les Masterson • May 23, 2017 -
South Carolina physicians upset over RVU payment plan
The Medical University of South Carolina Hospital will soon pay about 1,000 physicians based on the number of patients they treat rather than how much money each department generates.
By Les Masterson • May 22, 2017 -
Missouri hospital, clinic settle $34M false claims case
Mercy Hospital Springfield and Mercy Clinic Springfield Communities reportedly submitted false claims to Medicare for chemotherapy services.
By Les Masterson • May 22, 2017 -
Deep Dive
Uneasy payers seek more guidance as ACA exchange deadline nears
Payers are waiting to hear whether Republicans will continue to pay cost-sharing reduction payments.
By Les Masterson • May 22, 2017 -
Trump again threatens CSR payments, but delays court case
The White House on Monday asked for another 90-day delay in a lawsuit from House Republicans that argued the CSRs were being illegally funded.
By Shannon Muchmore • May 21, 2017 -
Report: ACA uncertainty hurting healthcare IPOs
Healthcare IPOs have only accounted for 21.1% of all IPOs so far this year, which is a 41.4% drop from last year.
By Les Masterson • May 18, 2017 -
CMS selects 4 more regions for CPC+
The agency expects to have up to 1,000 primary care practices participating in CPC+ Round 2.
By Ana Mulero • May 17, 2017 -
DOJ sues UnitedHealth for alleged Medicare Advantage mischarging, again
The move comes after a former UnitedHealth executive said officials changed diagnosis codes to make patients seem sicker and then collected bonuses.
By Les Masterson • May 17, 2017 -
Oscar Insurance reports lower losses in Q1 versus last year
The insurer lost $25.8 million in the first three months of 2017, which is less than the $48.5 million it lost a year earlier.
By Les Masterson • May 16, 2017 -
Harken Health shuts down after a year of cuts, losses
UnitedHealth started the company in 2015 to test an integrated model that offered primary care visits, mental health counseling and other services with no copays.
By Les Masterson • May 16, 2017 -
Kaiser Permanente announces $1B operating gain in Q1
The California health system had a 5.5% operating margin, which was an improvement from 4.3% in the first quarter of 2016.
By Les Masterson • May 16, 2017 -
CDC finds no health coverage gains from 2015 to 2016
A report released Tuesday showed 28.6 million Americans of all ages, or 9%, were uninsured in 2016.
By Shannon Muchmore • May 16, 2017 -
Survey: Value-based care shift is C-suite leaders' top strategic concern
A majority of surveyed U.S. healthcare executives don't think the Trump administration will slow down the move to value-based care.
By Meg Bryant • May 16, 2017 -
NJ governor moves for more control over profits of state's largest payer
Horizon Blue Cross Blue Shield of New Jersey reportedly rebuffed Gov. Chris Christie's request to give $300 million to the state’s addiction-treatment fund.
By Les Masterson • May 16, 2017 -
Zacks Investment Research downgrades Molina Healthcare after C-suite shake-up
Out of 13 brokerages that recently issued a ratings update for Molina, eight suggested “hold.” None of them rated the stock a “sell."
By Les Masterson • May 15, 2017 -
Deep Dive
What the last nail in the Anthem-Cigna coffin means for the healthcare industry
The end of the Anthem-Cigna merger gives other large payers "a chance to see how the Trump administration redefines the rules of the game,” Michael Abrams, managing partner at Numerof & Associates, told Healthcare Dive.
By Ana Mulero • May 15, 2017 -
More than 800K physicians get MACRA reporting reprieve for 2017
The change came after the CMS used an updated formula to estimate providers' Medicare revenue.
By Les Masterson • May 14, 2017 -
Geisinger, Highmark announce joint venture
The companies plan on building a new medical campus in rural Montoursville, Pennsylvania with the aim of improving population health.
By Meg Bryant • May 12, 2017 -
Anthem terminates Cigna merger
The two insurance giants have been battling over the proposed $54 billion merger in courthouses for several months.
By Ana Mulero • May 12, 2017 -
BCBS and Lyft team up to reduce patient no-shows
The collaboration will target communities that lack viable transportation alternatives.
By Meg Bryant • May 11, 2017
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