Payer: Page 164
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Appeals court: Maryland health co-op must make $24M risk adjustment payment
The co-op is optimistic it will be able to settle the balance.
By Ana Mulero • Aug. 2, 2016 -
Deep Dive
Consolidation in healthcare continues, but nontraditional alliances are also on the rise
More healthcare companies are looking to partner with organizations, rather than purchase them outright, an expert says.
By Meg Bryant • Aug. 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 -
Montgomery County Planning Commission
Aetna rethinks its ACA exchange strategy
The insurer, which plans to sell Medicare Advantage assets to Molina Healthcare, hopes the deal will ease antitrust concerns over the pending Humana merger.
By Jeff Byers • Aug. 2, 2016 -
New insurance data analysis shows how large the opioid epidemic is
Fair Health's analysis of claims data spanning 105 million individuals found medical services on an insurance claim with an opioid dependence diagnosis rose 3,203% from 2007 to 2014.
By Jeff Byers • Aug. 1, 2016 -
These 14 regions have been selected for CPC+
Practices can now apply to participate in the gamechanging primary care model.
By Jeff Byers • Aug. 1, 2016 -
Why DOJ is pushing against Anthem's speedy trial request over Cigna merger
Anthem hoped to meet its April target acquisition date by getting the trial over with.
By Heather Caspi • Aug. 1, 2016 -
Hospice, rehab, skilled-nursing facilities to face payment changes under 2017 Medicare rates
Payments will increase and new quality measures will be adopted once CMS' final rules become effective on October 1.
By Ana Mulero • Aug. 1, 2016 -
How to regulate insurance network adequacy?
Narrow health plan networks may offer consumers value, but they also pose risks.
By Meg Bryant • July 29, 2016 -
Not a good day for Cigna after Q2 earnings release
CEO David Cordani noted if the Justice Department is successful in blocking the pending Anthem merger, Cigna will have "$5 billion in deployable cash."
By Jeff Byers • July 29, 2016 -
Deep Dive
ZendyHealth doubles down on patient consumerism with Pick-Your-Price feature
“There's going to be room for a lot of players like this,” said Founder & Chief Medical Officer Vish Banthia.
By Jeff Byers • July 28, 2016 -
Seniors decry automatic enrollment in Medicare Advantage plans
CMS officials are not saying how long the process has been going on.
By Heather Caspi • July 28, 2016 -
Anthem Q2 profits drop amid uncertain transaction with Cigna
The insurance giant is grappling with increased medical spending on top of its fight with the DOJ. The insurer's CEO said the pending Cigna acquisition "will help stabilize pricing" in the ACA market.
By Heather Caspi • July 28, 2016 -
Centene suffers stock drop over Health Net despite strong Q2 profit
The acquisition of Health Net has posed problems for Centene in the second quarter. In addition, Centene is giving possible Humana/Aetna divestitures a hard pass.
By Heather Caspi • July 27, 2016 -
Oscar hopeful slashing NY provider network in half will help scaling efforts
Cutting its 2017 provider network in New York in half from 40,000 to 20,000, the insurance startup is really banking on its tech savvy to beef up profits.
By Heather Caspi • July 27, 2016 -
Zoom+, Blue Cross settle suit over logo similarity
Blue Cross had fought Zoom in 2015 over its adoption of a blue cross logo.
By Heather Caspi • July 27, 2016 -
All states now providing CHIP with Arizona back in program
The state has re-opened enrollment in the Children’s Health Insurance Program.
By Heather Caspi • July 26, 2016 -
You're cordially invited to submit comments on the controversial Open Payments
Policy around required payment disclosures are set to get a second look.
By Heather Caspi • July 26, 2016 -
How UnitedHealthcare is making a purchase offer this Colorado insurer can't refuse
In exchange for access and a presence in Colorado's Medicaid market, the payer is investing to stabilize Rocky Mountain Health Plans.
By Ana Mulero • July 26, 2016 -
Cigna to Chicago ACA market: We want in
As insurers are exiting the marketplaces across the country, Cigna sees an opportunity in the Windy City.
By Jeff Byers • July 26, 2016 -
Zenefits pays $62,500 fine in TN to continue operations in the state
Paying down fines and settling issues upfront could be the beginning of the firm's comeback.
By Tom Starner • July 26, 2016 -
Deep Dive
Are insurers ditching PPOs?
One insider says PPO plans make the transition to alternate value based-payment models difficult since patients are not necessarily tied to a particular provider.
By Julie Henry • July 26, 2016 -
DoD's Tricare cuts UnitedHealthcare from $58B contract collection
Humana stands to benefit big from UnitedHealthcare's loss.
By Heather Caspi • July 25, 2016 -
Hospital M&A activity up 6.1% so far against last year
Should federal regulators put a stop to industry consolidation?
By Jeff Byers • July 25, 2016 -
CMS dips further into Medicare bundled payments. This time with cardiac care
The agency released its final rule on bundled joint replacement payments last November.
By Jeff Byers • July 25, 2016 -
Slavitt details MACRA commentators' 5 priority areas
The CMS acting administrator touted record engagement in the policywriting process.
By Heather Caspi • July 25, 2016
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