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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 -
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 -
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 -
OIG: Florida Medicaid program paid $26M to private payers for dead beneficiaries
The overpayments have raised some concern over the costs associated with a privately administered Medicaid model.
By Luke Gale • Dec. 15, 2016 -
Medisafe, major EHRs spotlight interoperable medication lists
A new report by Surescripts shows 93% of surveyed patients favor storing all their medications in one location.
By Meg Bryant • Dec. 15, 2016 -
Carequality, CommonWell partner on interoperability, data sharing
The collaboration’s aim is to make it easier for providers to get health information that could be useful in making decisions about diagnosis and treatment for their patients.
By Meg Bryant • Dec. 15, 2016 -
Alex Wong via Getty Images
HHS takes stock of uninsured rates, quality of care under ACA
With the future of the ACA in question, HHS released new data stumping for the legislation’s effectiveness.
By Kathleen McGuire Gilbert • Dec. 14, 2016 -
CVS Health launching an analytics-based initiative to deliver personalized diabetes care
The company hopes its new program will allow each participating client to save as much as $5,000 annually.
By Luke Gale • Dec. 14, 2016 -
Humana CEO offers 5-point plan for curbing ER use
Primary care providers should act as the “quarterback” in the healthcare system, directing patients to specialists as needed and helping to reduce unnecessary ER visits, CEO Bruce Broussard says.
By Meg Bryant • Dec. 13, 2016 -
HHS: Preventing hospital-acquired infections saved $28B
More than 3 million of such infections were prevented from 2010 through 2015, according to the agency.
By Ana Mulero & Jeff Byers • Dec. 12, 2016 -
Oscar, Mount Sinai cut ribbon on new Brooklyn clinic
Convenience is a hot topic in healthcare these days and the insurer could be looking long-term toward a chain of clinics across the U.S.
By Meg Bryant • Dec. 9, 2016 -
Evergreen dropped from Maryland's 2017 individual insurance market
The health insurance co-op has been trying to segue into a for-profit status after facing financial ruin earlier this year.
By Meg Bryant • Dec. 9, 2016 -
CMS aims to empower patients with new engagement models
Organizations can begin applying now.
By Ana Mulero • Dec. 9, 2016 -
Humana writes off $591M risk corridor receivables
The payer anticipates collection of approximately $8 million in risk corridor receivables outstanding as of September 30.
By Jeff Byers • Dec. 8, 2016 -
AHIP: ACA repeal-and-replace can be done 'responsibly'
CEO and President Marilyn Tavenner believes the individual mandate is likely on the chopping block.
By Ana Mulero • Dec. 8, 2016 -
Deep Dive
What a Trump administration may mean for digital health
Trump will likely focus on cutting employers’ healthcare costs, which could bode well for digital apps and other technologies that can help keep people healthy.
By Meg Bryant • Dec. 8, 2016 -
Deep Dive
Bringing the company to life 'inside out': Humana on its PTO policies
Understanding the unmet needs and preferences of employees can help healthcare organizations to design paid-time off policies.
By Luke Gale • Dec. 6, 2016 -
Hospital groups: ACA repeal may cost billions, jobs
The American Hospital Association and the Federation of American Hospitals released two reports on how repealing the ACA could impact U.S. hospitals and patients. It isn't pretty.
By Ana Mulero • Dec. 6, 2016 -
USA Today: ACA critic made $400M from Obamacare plans
Blue Cross Blue Shield of North Carolina spokeswoman Darcie Dearth told the publication new customers are a "big unknown."
By Ana Mulero • Dec. 6, 2016 -
Psychedelic mushrooms provide depression, anxiety relief among cancer patients
Psilocybin, the active ingredient in psychedelic mushrooms, has been illegal in the U.S. since the 1970s.
By Meg Bryant • Dec. 2, 2016 -
Fortune picks healthcare stock winners for a Trump White House
Pharma companies stand to gain from the 21st Century Cures Act, which has a number of provisions aimed at speeding up drug approvals.
By Meg Bryant • Dec. 2, 2016 -
MACRA committee now accepting APM proposals
There are a number of criteria that must be met in order for the committee to include a proposal in its recommendations to the HHS Secretary.
By Ana Mulero • Dec. 2, 2016 -
Democratic opponents take aim at Cures bill in final hours
The fate of the legislation remains uncertain in the midst of high-profile opposition and last-minute changes.
By Heather Caspi • Nov. 30, 2016
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