Payer: Page 149
-
Cigna could soon end proposed $54B Anthem merger after latest court ruling
"We look forward to closing this final chapter,” a Cigna representative said. A Delaware court on Thursday denied Anthem's request to block Cigna from terminating the merger.
By Ana Mulero • May 11, 2017 -
Deep Dive
MACRA: Why cloud-based solutions could be the answer for small practices
Most (80%) of the medical practices with 15 physicians or fewer that were recently surveyed by Healthcare Informatics said they were not ready for MACRA or needed help.
By Meg Bryant • May 11, 2017 -
Montgomery County Planning Commission
Aetna will not participate in ACA exchanges at all next year
The insurer said it is pulling out because of financial losses, adding that its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.
By Shannon Muchmore • May 11, 2017 -
Feds would need to modify risk adjustment program if changes are made to ACA exchanges
The American Academy of Actuaries said some of the changes could include “major structural modifications.”
By Les Masterson • May 11, 2017 -
BCBS of TN steps forward to fill ACA exchange gap
The insurer said it will participate in ACA exchanges covering 16 eastern Tennessee counties that currently have no payer in place for next year.
By Les Masterson • May 9, 2017 -
With 'long-shot' appeal pending, Anthem seeks extension of restraining order on Cigna
An Anthem attorney argued the company could come to an agreement with the presidential administration after its officials are confirmed to have its $54 billion transaction go through.
By Ana Mulero • May 9, 2017 -
Justice Department appeals Moda Health risk corridor decision
The CMS has not paid insurers the full amount owed through the risk corridor program, instead paying a proportional allocation.
By Les Masterson • May 9, 2017 -
AHCA backers want to use payer unease over exchanges, rates to their advantage
Payers still don't know if they will continue to receive cost-sharing reduction payments, but they face deadlines for setting 2018 rates and deciding whether to participate in ACA exchanges.
By Les Masterson • May 8, 2017 -
AHA president calls on Senate to 'reset' ACA repeal discussion
The House passed the AHCA last week despite heavy opposition from top lobbying organizations in the healthcare industry.
By Ana Mulero • May 8, 2017 -
Deep Dive
Some hospitals may not survive AHCA: 3 thoughts on the House vote from a healthcare attorney
"We're going to see a crisis in access to care. We're going to have care deserts," if the AHCA is passed as written, said Delphine O'Rourke, a managing partner at Hall, Render, Killian, Heath & Lyman.
By Jeff Byers • May 5, 2017 -
Anthem takes proposed Cigna merger to Supreme Court
Anthem was expected to call off the merger after failing to demonstrate that the claimed efficiencies would offset any potential harm on competition in the health insurance market.
By Ana Mulero • May 5, 2017 -
UPMC operating revenues grow to $11B
The growth bucks a current trend where hospitals and health systems are experiencing a decrease in operating revenues.
By Jeff Byers , Les Masterson • May 4, 2017 -
Study: Telemental health use remains low, varies across states
The number of virtual visits grew on average 45.1% annually among Medicare patients diagnosed with a mental illness, a new study in Health Affairs concluded.
By Meg Bryant • May 3, 2017 -
Humana: Failed Aetna merger boosted Q1 profits
The Louisville-based payer received a $947 million pre-tax payment as part of the failed $37 billion merger with Aetna.
By Les Masterson • May 3, 2017 -
Molina Healthcare abruptly removes outspoken CEO after 'disappointing financial performance'
The insurance company’s board of directors removed President and CEO Dr. J. Mario Molina and CFO John C. Molina from their positions.
By Les Masterson • May 2, 2017 -
Montgomery County Planning Commission
Aetna loses $381M in Q1, to leave VA exchange market in 2018
Company officials called the first quarter a “strong start to the year despite costs associated with the termination of the Humana merger agreement.”
By Les Masterson • May 2, 2017 -
JAMA: Physicians received $2.4B in industry-related payments in 2015
Surgeons received a “higher value of payments” than primary care doctors, as did male physicians compared to female physicians.
By Les Masterson • May 2, 2017 -
Deep Dive
Why Anthem and Cigna can't convince judges they should merge
The $54 billion deal to create the largest health insurance company in the country is still on because, although Cigna has been at best a reluctant participant for months, Anthem won’t give up.
By Ana Mulero • May 2, 2017 -
WellCare purchases Universal American Corp., grows Medicare Advantage members
WellCare will gain Universal American Corp.'s 119,000 Medicare Advantage members in Texas, New York and Maine. Universal American Corp’s President and CEO Richard Barasch will also leave the company as part of the acquisition.
By Les Masterson • May 1, 2017 -
New report trumpets Medicaid enrollees' access to healthcare
The Commonwealth Fund found that Medicaid enrollees have nearly the same access to healthcare as those with private insurance.
By Les Masterson • April 28, 2017 -
Anthem steadfast in commitment to increasingly unlikely Cigna merger
Anthem failed to “show the kind of extraordinary efficiencies necessary to offset the conceded anti-competitive effect" of the $54 billion transaction proposed in 2015, according to the U.S. Court of Appeals District of Columbia Circuit.
By Ana Mulero • April 28, 2017 -
Kaiser Permanente, other heavy hitters call for value-based healthcare model
Several key health leaders announced pilot programs beginning with a value-based plan to treat heart failure in the Atlanta area.
By Les Masterson • April 27, 2017 -
Anthem beats earnings predictions, intends to issue 2018 ACA ratings
The giant health insurance company made $1 billion in the first quarter of 2017, which is a 44% increase over the same period in 2016.
By Les Masterson • April 26, 2017 -
Kaiser Permanente CEO reports strong use of telehealth
The integrated health system invests about 25% of its $3.8 billion annual spend on health IT.
By Meg Bryant • April 25, 2017 -
Centene commits to ACA exchanges for 2018, basks in 69% revenue growth
The St. Louis-based health insurance company trumpeted more managed care members and a lower health benefits ratio in its Q1 2017 results.
By Les Masterson • April 25, 2017
Previous
