Payer: Page 157
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Deep Dive
What Trump's executive order could mean for the ACA
On Thursday, the Trump administration announced it would cease advertising ACA coverage in the final days of the current open enrollment season.
By Meg Bryant • Jan. 27, 2017 -
ACA uncertainty causes insurers to 'rethink participation'
Without cost-sharing subsidies, many health insurance companies could exit the ACA marketplaces.
By Meg Bryant • Jan. 27, 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 -
Anthem tries to play Aetna-Humana defeat to its advantage
In a court filing, Anthem argued the Aetna-Humana case confirms that "the procompetitive effects generated by the efficiencies should be weighed against any possible anticompetitive effects."
By Meg Bryant • Jan. 27, 2017 -
Deep Dive
How alternative settings unlock healthcare access — and eat into hospitals
It's all about the access. U.S. retail clinics have nearly tripled over the past decade and some providers are betting the trend toward consumerization will continue.
By Jeff Byers , Luke Gale • Jan. 26, 2017 -
Telehealth increasingly seen as criteria for choosing primary doc, study finds
Most willing to switch doctors were parents of children under age 18 and 35 to 44 year olds, American Well stated.
By Meg Bryant • Jan. 26, 2017 -
Insurers proposing ideas for Obamacare replacement
Companies are making a case to Republicans to preserve some aspects of the ACA, but the devil is in the details.
By Kathleen Gilbert • Jan. 26, 2017 -
AMA-led coalition calls for reforming management tools
Fed up with the burden of utilization management tools like prior authorization, a group representing healthcare providers and patients has made it clear that they want to see big changes from payers.
By Kathleen Gilbert • Jan. 26, 2017 -
New bariatric surgery clinic opening highlights business opportunities
There’s no question that the number of Americans who are candidates for bariatric surgery is increasing. But in a turbulent insurance market, how many will pay for the procedure?
By Kathleen Gilbert • Jan. 26, 2017 -
After court block, Aetna and Humana consider next steps
The prospects for a successful appeal of Monday’s decision don’t look great, but the health insurance giants say they’re considering all possibilities.
By Kathleen Gilbert • Jan. 25, 2017 -
Minorities with a chronic condition lack coverage even under ACA
The authors of a new study published in the Annals of Internal Medicine suggest an ACA replacement plan most likely to provide both coverage and access to care for those with a chronic illness would be a “comprehensive Medicare-for-All” plan.
By Kathleen Gilbert • Jan. 25, 2017 -
Deep Dive
Healthcare M&A down but not out in 2016, PwC finds
While the number of deals decreased 1.4% year-over-year, healthcare is still a very active market, Thad Kresho, U.S. Health Services Deals Leader at PwC, told Healthcare Dive.
By Jeff Byers • Jan. 24, 2017 -
Banner Health, Philips underscore telehealth value in high-cost populations
The electronics company's Intensive Ambulatory Care pilot program helped cut hospitalizations and overall costs.
By Meg Bryant • Jan. 24, 2017 -
Cigna ordered to reverse its policies on autism coverage
Being forced to comply with mental health parity laws is bound to be expensive, adding to Cigna’s financial woes.
By Kathleen Gilbert • Jan. 23, 2017 -
Judge blocks Aetna-Humana merger
A federal judge stopped the proposed $37 billion merger between insurance giants Aetna and Humana over antitrust concerns. The news comes as another mega-merger between insurers — Cigna and Anthem — also faces scrutiny.
By Ana Mulero • Jan. 23, 2017 -
Judge blocks Aetna-Humana merger
A federal judge stopped the proposed $37 billion merger between insurance giants Aetna and Humana over antitrust concerns. The news comes as another mega-merger between insurers — Cigna and Anthem — also faces scrutiny.
By Ana Mulero • Jan. 23, 2017 -
$54B Anthem-Cigna deal could be blocked
Anthem is extending the deadline for completion of its merger agreement with Cigna, which is considering its options.
By Kathleen Gilbert • Jan. 23, 2017 -
On Day One, Trump starts unwinding ACA
In an executive order issued on Friday, federal healthcare agencies are instructed to "waive, defer, grant exemptions from or delay implementation of any provision or requirement" that imposes a burden on individuals, payers, healthcare providers, among others.
By Ana Mulero • Jan. 23, 2017 -
US recovered $3.3B in fraudulent healthcare claims in 2016
One of the year’s biggest settlements was with Tenet Healthcare for $390 million.
By Meg Bryant • Jan. 20, 2017 -
Providing primary care in the home saves money, CMS says
While home-based primary care services can reduce costs of caring for elderly patients by reducing the need for hospitalizations, they are not widely available to those who could benefit the most.
By Luke Gale • Jan. 20, 2017 -
CMS reins in pass-through payments
Safety-net hospitals, clinics and physicians will be looking for new income streams to replace billions in payments that are being phased out.
By Kathleen Gilbert • Jan. 19, 2017 -
We may be able to avoid casualties in the ACA battle, according to one proposed replacement plan
A new set of ideas offers more detail than we’ve seen before but will require buy-in from employers.
By Kathleen Gilbert • Jan. 19, 2017 -
Retail clinics thriving despite little use by the individually insured, study shows
Retail clinics are less expensive and more convenient than emergency room visits, but surprisingly, the individually insured are not the ones fueling their popularity.
By Kathleen Gilbert • Jan. 19, 2017 -
Deep Dive
No punches pulled during Tom Price's HHS courtesy hearing
From healthcare stocks and ACA repeal to EHRs, committee members weren't shy while interrogating Trump's HHS Secretary nominee.
By Ana Mulero • Jan. 18, 2017 -
UnitedHealth Group ends 2016 on a high note amid ACA uncertainty
The company posted more than $13 billion in operating earnings – a performance driven largely by its pharmacy benefits management and technology services lines of business.
By Luke Gale • Jan. 18, 2017 -
ONC, CMS offer roadmap for continued shift to value-based payments
Barriers and frustrations around the digitization of healthcare remain, National Coordinator for Health IT Dr. Vindell Washington and CMS acting Administrator Andy Slavitt wrote in a recent blog post.
By Meg Bryant • Jan. 18, 2017
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