Payer: Page 151
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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 -
Feds disclose False Claims Act investigation into multiple payers
UnitedHealth, Aetna, Bravo Health, Cigna, Health Net and Humana have all been named in a lawsuit that alleges the payers cheated the government out of hundreds of millions of dollars.
By Luke Gale • March 20, 2017 -
Reports: Trump to pick former Anthem lobbyist to head DOJ antitrust division
The lobbying firm White House Deputy Counsel Makan Delrahim worked for, Brownstein Hyatt Farber Schreck, participated in the “antitrust issues associated with Anthem's proposed acquisition of Cigna.”
By Ana Mulero • March 20, 2017 -
AHA: Anthem-Cigna would hinder innovation needed for value-based care shift
The organization says court documents suggest "Anthem has been less willing than Cigna to innovate to develop value-based reimbursement systems."
By Ana Mulero • March 17, 2017 -
WSJ: Clover Health eyes $120M to join the unicorns
Investors have delivered serious amounts of cash to health insurance startups in recent years.
By Luke Gale • March 16, 2017 -
Deep Dive
How to get better value from telehealth
“If you give consumers a convenient alternative, they will take advantage of it,” RAND Corporation’s Scott Ashwood said.
By Meg Bryant • March 16, 2017 -
Mayo Clinic to give preferential treatment to privately insured patients
The decision was driven by rising uncompensated care costs associated with treating Medicaid patients and low Medicaid reimbursement rates.
By Luke Gale • March 16, 2017
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