Payer: Page 163
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Deep Dive
Why selling insurance across state lines is an unlikely solution
Proposals to allow the sale of health insurance across state lines make a lot of promises that would likely go unfulfilled.
By Luke Gale • Nov. 2, 2016 -
CMS issues final rule on hospital payment rates for 2017
The agency followed through on a proposal to remove patient survey answers as part of pain management care in the Value-Based Purchasing program.
By Luke Gale • Nov. 2, 2016 -
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 -
Updated payment process aims to reshape RAC program
Along with new contracts come updates to how RACs are paid, audit timelines and the review process.
By Heather Caspi • Nov. 2, 2016 -
Trump raises questions with promise for special session to repeal ACA
Concern has been stirred once again by Trump's language.
By Heather Caspi • Nov. 2, 2016 -
Blue Shield of California repays millions in rebates, again
The company stands out among insurers for the amount of money its owed.
By Heather Caspi • Nov. 2, 2016 -
NorthShore/Advocate merger has been put on ice by a federal appeals court
A recent JAMA Forum discussion opined the future of ACA could potentially be at the mercy of provider consolidation.
By Heather Caspi • Nov. 1, 2016 -
Physician participation dips in marketplace plans, SERMO says
With lessened insurer participation comes lessened provider participation.
By Heather Caspi • Nov. 1, 2016 -
HHS restricts short-term insurance plans to under 3 months
Americans that purchase short-term plans will have to pay the individual penalty as they won't have ACA-compliant coverage and health insurers must notify their customers under the new rule.
By Ana Mulero • Oct. 31, 2016 -
Survey: 29% of physicians still haven't heard of MACRA
With the final rule now out, physicians should be making their plans for 2017.
By Heather Caspi • Oct. 31, 2016 -
Patient ratings added to Dialysis Facility Compare website
CMS is furthering its push for transparency and improved accuracy in star ratings.
By Heather Caspi • Oct. 31, 2016 -
Patient factors dominate readmissions risks, study finds
The findings contribute to the discussion whether current Medicare policy is unfairly penalizing hospitals with significant poor and minority populations when it comes to readmission rates.
By Heather Caspi • Oct. 30, 2016 -
Deep Dive
Technology, outreach efforts prime ACA open enrollment season
Mobile apps, Lyft partnerships and "hyperlocal" outreach have been included in efforts to boost insurance enrollment.
By Jeff Byers • Oct. 29, 2016 -
Montgomery County Planning Commission
Aetna profits from government programs, just not ACA
Sales of plans through Medicare and Medicaid contracts helped fuel a strong third quarter for the insurance giant.
By Meg Bryant • Oct. 28, 2016 -
AHA sees erosion of physician judgment in DOJ false claims suit
DOJ accused Prime Healthcare of encouraging doctors to admit Medicare patients for short hospital stays instead of outpatient observation care.
By Meg Bryant • Oct. 28, 2016 -
ACA marketplace stability, or lack thereof, to come into focus in 2017
Kaiser Family Foundation's CEO Drew Altman's argues next year's insurer quarterly earnings reports will show whether their rates are aligning with their costs.
By Heather Caspi • Oct. 27, 2016 -
Study: Insurance cost squeeze on workers real, though premiums not to blame
While cost growth has slowed since the ACA, incomes have not kept up.
By Heather Caspi • Oct. 27, 2016 -
Covered California highlights recipe for individual marketplace success
The state shares how it has made the health law work for the most part.
By Heather Caspi • Oct. 26, 2016 -
Deep Dive
Ignorance around 'Obamacare' impairs discussion
Trump made some remarks on the ACA on Tuesday which didn't add up.
By Heather Caspi • Oct. 26, 2016 -
Deep Dive
How payers are tackling value-based drug pricing
Efforts to establish such pricing are on the rise as payers and providers challenge drug makers to help improve health outcomes. However, barriers to these payment models remain.
By Luke Gale • Oct. 26, 2016 -
Deep Dive
Advanced APMs: What they are and why they matter
Providers should look at both the downside risk potential and cost of implementing an Advanced APM.
By Meg Bryant • Oct. 26, 2016 -
HHS touts strides on delivery system reform goals
Public and private progress toward spending through alternative payment models is going strong.
By Heather Caspi • Oct. 26, 2016 -
Medicaid expansion, Health Net acquisition main drivers in Centene Q3 growth
Revenue grew year-over-year by 86%.
By Jeff Byers • Oct. 25, 2016 -
CMS pivots from Medicare Advantage auto-enrollment for internal review
The agency is not currently allowing any new insurers to use "seamless conversion," but disclosed 29 have already been approved.
By Heather Caspi • Oct. 25, 2016 -
CMS pushes for more MACRA participation with new Advanced APM options
An Oncology Care Model track will now qualify as an Advanced APM for the 2017 performance year.
By Ana Mulero • Oct. 25, 2016 -
AARP sues the EEOC over new wellness incentive rules
The advocacy group expressed concern that wellness program incentives may be too onerous for some employees.
By Kathryn Moody • Oct. 25, 2016
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