Payer: Page


  • Oscar looks beyond the ACA for business

    Whatever the ACA’s future may be, Oscar plans to stay in the health insurance game.

    By Kathleen Gilbert • Jan. 8, 2017
  • Medicare backed off under pressure from health insurers

    Audits of Medicare’s books show that it settled for recouping nearly $3.4 million in overpayments instead of the $128 million that it was owed from five health plans.

    By Kathleen Gilbert • Jan. 8, 2017
  • Explore the Trendline
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    Trendline

    Payer/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
  • HHS: Coverage of Americans with preexisting conditions up since ACA

    Roughly 133 million nonelderly Americans — or 51% — have a preexisting medical condition.

    By Jan. 6, 2017
  • NQF guidance aims to reduce quality measure variation

    The guidance provides a decision-logic framework for determining if variation exists and how to address it.

    By Jan. 6, 2017
  • Paul Ryan: ACA repeal would strip Planned Parenthood funding

    The nonprofilt reproductive health services organization launched a petition this week to ask Congress for its support.

    By Jan. 6, 2017
  • 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
  • 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 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
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    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 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 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 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 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
  • 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 Dec. 30, 2016
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    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 Dec. 30, 2016
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    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
  • 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 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 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 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 Dec. 20, 2016
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    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 Dec. 20, 2016
  • Last week held a banner day for ACA signups

    The uptick in enrollment suggests greater ACA risk pool stabilization.

    By Dec. 19, 2016