Payer: Page 159
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ACA Round-Up: Fault lines show as ACA battle wages on
Democrats work to rally public support while Republicans strive to move quickly to dismantle Obamacare in this political minefield.
By Kathleen McGuire Gilbert • Jan. 5, 2017 -
CMS joint bundle payments shoring up savings, researchers find
Though results have been mixed, CMS is forging ahead with expansions to the bundled payment program.
By Kathleen McGuire Gilbert • Jan. 5, 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 -
Healthcare industry continues to weigh in on ACA reform
The Healthcare Leadership Council recommended actions that aim to "bolster the stability of the health insurance marketplace, encourage greater competition, and give all Americans enhanced choice and flexibility in their coverage."
By Ana Mulero • Jan. 5, 2017 -
Deep Dive
What's at stake across the industry for ACA repeal and delay
Let's take a beat to assess the storylines behind the new "if you like your plan, you can keep it" battle.
By Jeff Byers & Meg Bryant • Jan. 4, 2017 -
UnitedHealthcare partners with Fitbit to boost workplace wellness program participation
The managed care company will give participants the opportunity to benefit financially from meeting activity goals monitored by the wearable.
By Kathleen McGuire Gilbert • Jan. 4, 2017 -
Pop health vendors challenged by range of provider needs
“The world of population health is so vast that there is not one vendor that does it all for providers,” says KLAS’ Bradley Hunter.
By Meg Bryant • Jan. 4, 2017 -
Bizwomen: Johns Hopkins Hospital president not 'nervous' for healthcare over incoming White House admin
President Redonda Miller hopes portions of the ACA "that have been beneficial to patients" will be retained.
By Ana Mulero • Jan. 3, 2017 -
Deep Dive
What we're watching on the road ahead in 2017
Get ready; 2017 will go by faster than you think as the industry changes.
By Jeff Byers • Jan. 3, 2017 -
Antitrust trial over $37B Aetna-Humana merger nearing an end
The legal battle between the health insurance giants and the federal government has raged for months.
By Luke Gale • Jan. 3, 2017 -
Judge rejects legal challenge to EEOC wellness program rule
The shift to value-based care has seen the proliferation of workplace wellness programs.
By Meg Bryant • Jan. 3, 2017 -
OIG: New Jersey falsely claimed $94M worth of Medicaid reimbursements
OIG recommended the state agency refunds the money to the federal government. The state disagreed.
By Jeff Byers • Dec. 30, 2016 -
Deep Dive
The optimism and challenges for putting the 'value' in value-based care
Providers describe a “sweet spot” between getting optimal quality and achieving that at a reasonable cost.
By Meg Bryant • Dec. 30, 2016 -
Aetna, Humana extend planned merger end date
A federal judge is expected to rule on the government’s antitrust lawsuit to block the megamerger sometime in January.
By Meg Bryant • Dec. 23, 2016 -
S&P says 2017 a 'one-time pricing correction' for ACA markets
The report predicts next year will see the insurers that sell ACA plans "getting close to break even or better."
By Jeff Byers & Meg Bryant • Dec. 23, 2016 -
Deep Dive
2016 may be the end of the ACA blame game
Consumers have been facing greater price increases, as well as monopolies in the health insurance and medical fields.
By Ana Mulero • Dec. 22, 2016 -
Deep Dive
How payers are responding to the opioid crisis
With the cost of claims associated with opioid abuse and dependence skyrocketing, payers are using analytics and working with providers and patients to address the problem.
By Luke Gale • Dec. 21, 2016 -
CBO: Minimal insurance products not counted as coverage
The definition of "health coverage" will be a hot topic as the GOP preps an ACA replacement plan.
By Jeff Byers • Dec. 20, 2016 -
Deep Dive
New CMS APMs finalize cardiac, orthopedic bundled payment models
The agency also finalized the Medicare ACO Track 1+ Model to encourage smaller practices to participate in performance-based risk.
By Ana Mulero • Dec. 20, 2016 -
Federal task force reveals evidence gaps in preventive health services
Areas where more research is needed include autism screening and aspirin therapy to prevent cardiovascular disease and colorectal cancer.
By Meg Bryant • Dec. 20, 2016 -
Last week held a banner day for ACA signups
The uptick in enrollment suggests greater ACA risk pool stabilization.
By Jeff Byers • Dec. 19, 2016 -
Alex Wong via Getty Images
CMS aims at stabilizing risk pool with 2018 ACA exchange rule
The new risk adjustment model will incorporate prescription drug data, among other modifications.
By Ana Mulero • Dec. 19, 2016 -
Government can't pay insurers billions owed for risk corridors
The risk corridor program was supposed to help payers recoup costs spent on the sickest patients in the individual insurance markets. It hasn't worked out as planned and payers are receiving a fraction of the money they are owed.
By Luke Gale • Dec. 19, 2016 -
CMS adds two more Advanced APMs in press to grow participation
CMS expects 25% of clinicians will participate in Advanced Alternative Payment Models by 2018.
By Meg Bryant and Ana Mulero • Dec. 16, 2016 -
20% of ER inpatient cases result in surprise medical bills
States with the highest rates of surprise medical bills include New York, New Jersey and Texas, according to a new study published in Health Affairs.
By Meg Bryant • Dec. 16, 2016 -
Top 1% would see big tax cut with ACA repeal
Republican plans to dismantle Obamacare would end health insurance for millions of Americans — and do away with several taxes on high-income households.
By Meg Bryant • Dec. 16, 2016
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