Payer: Page 163
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Performance pressures cause hospitals to deny risky transplants
In the first five years since the government set organ transplant standards, more than 4,300 candidates were dropped from waiting lists.
By Meg Bryant • Aug. 12, 2016 -
ACO's integration of behavioral health yields 13% decrease in ED visits, study finds
The program at UCLA Health is showing strong results nearly three years in.
By Heather Caspi • Aug. 11, 2016 -
Explore the Trendlineâž”
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 -
CMS refines upcoming value-based Medicare Advantage model
Changes are in store for the second year of the program in 2018.
By Heather Caspi • Aug. 11, 2016 -
Telehealth shines in new employer healthcare benefits analysis for 2017
The National Business Group on Health estimates overall employee health benefit costs will rise 6% next year. Many insurers have been proposing double-digit premium rate increases for the ACA exchanges in 2017.
By Meg Bryant • Aug. 10, 2016 -
Bending of Medicare cost curve projected to save $2 trillion
The massive spending reduction indicates the long term viability of Medicare, the study suggests.
By Heather Caspi • Aug. 10, 2016 -
Deep Dive
Increase in parity supports building out mental health informatics
The lack of robust, standardized data fields for behavioral health could be an opportunity for health IT vendors.
By Jeff Byers • Aug. 10, 2016 -
Montgomery County Planning Commission
Aetna/Humana-DOJ antitrust trial date set for December
The date is later than the insurers were requesting.
By Jeff Byers • Aug. 10, 2016 -
Study findings fuel debate over whether Medicare Advantage offers better care at a lower cost
Medicare Advantage plans pay hospitals an average of 5.6% less for services than fee-for-service Medicare, according to a recent analysis.
By Heather Caspi • Aug. 10, 2016 -
Medicaid expansion good for states' bottom lines, study says
Participating states are seeing net budgetary gains despite some increased spending on their Medicare programs.
By Heather Caspi • Aug. 9, 2016 -
Connecticut exchange coverage could take hits over threat of dwindling broker commissions
If commissions go, brokers are set to leave as well.
By Heather Caspi • Aug. 9, 2016 -
ACA squashed formation of physician-owned hospitals, study finds
Restrictions on new POHs have rendered them non-viable, researchers say.
By Heather Caspi • Aug. 9, 2016 -
The last major insurer on Alabama ACA market is seeking an average 39% individual premium hike
The proposed rates could affect more than 160,000 individuals.
By Jeff Byers • Aug. 8, 2016 -
Harken Health withdraws from ACA expansion plans into South Florida
While reasons behind the reversal are currently unknown, Harken Health will instead plan to expand the number of its primary care clinics in Atlanta and Georgia.
By Ana Mulero • Aug. 8, 2016 -
Medicaid expansion leads to better healthcare outcomes, study finds
Adopting expansion was associated with an increase of access to primary care by 12.1 percentage points.
By Ana Mulero • Aug. 8, 2016 -
Moving on up: New York releases approved health insurance rates for 2017
Only four of the 17 companies listed had an approved premium percentage increase under double-digits.
By Jeff Byers • Aug. 6, 2016 -
Cigna preps Plan B in face of potential Anthem merger dissolution
By the first half of 2017, Cigna could potentially have $5 billion to play with and explore share buybacks or different acquisitions.
By Jeff Byers • Aug. 6, 2016 -
DC judge shuffles megamerger cases, hands off Anthem/Cigna suit
Anthem's case was reassigned to U.S. District Judge Amy Berman Jackson, court filings show.
By Ana Mulero • Aug. 5, 2016 -
NY's MVP Health Care seeks bigger footprint in Medicaid market
Managed care has been at the forefront of New York’s Medicaid population growth since the state expanded eligibility under the ACA.
By Meg Bryant • Aug. 5, 2016 -
UnitedHealth doles out $148 in value-based bonuses to docs
Over the past three years, UnitedHealthcare has paid out $48 billion to providers.
By Meg Bryant • Aug. 5, 2016 -
UnitedHealth appeals loss of $58B Tricare contract collection
If GAO agrees with UnitedHealth, the Department of Defense could reopen bidding or reconsider UnitedHealth’s proposals.
By Meg Bryant • Aug. 5, 2016 -
Aetna is also urging DOJ for speedy trial over pending Humana merger
While Aetna and Anthem are pushing for quick, separate trials over their megamergers, the Justice Department says it could be ready for trial as soon as February 17, 2017.
By Ana Mulero • Aug. 3, 2016 -
This may hurt a little: Readmission penalties expected to reach new record for hospitals
More than half a billion dollars in payments will be withheld from hospitals when the new penalties take effect in October.
By Ana Mulero • Aug. 3, 2016 -
Deep Dive
What the new mandatory bundled payments for cardiac care could mean for the industry
One expert believes the industry can expect to see similar models on the horizon for oncology and maternity care.
By Julie Henry • Aug. 3, 2016 -
Humana outlines ACA market withdrawal in Q2 earnings report
The carrier stated it's pulling back individual market operations to "no more than 156 counties" in 11 states.
By Jeff Byers • Aug. 3, 2016 -
CMS final rule 'permanently' removes controversial two-midnight payment cut
All in all, the agency estimated that total Medicare spending on inpatient hospital services will increase by about $746 million in FY 2017.
By Jeff Byers • Aug. 2, 2016
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