Payer: Page 166
-
CMS, FDA want device identifiers on Medicare claims forms
Collecting UDI data on claims forms would let providers and payers compare costs and outcomes of implants at the model level.
By Meg Bryant • July 15, 2016 -
Employer-sponsored insurance stable under ACA, survey states
The ACA may so far be more of a help than a hindrance to the take-up of employer-sponsored insurance.
By Heather Caspi • July 14, 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 -
New Mexico's largest health plan drops out of ACA for 2017
Presbyterian is ditching the market after finding its ACA enrollees to be using 30% more healthcare than others.
By Heather Caspi • July 13, 2016 -
CMS projects hospital spending to grow 5.8% annually over 2015-2025
Overall, national health expenditures are estimated to have reached $3.2 trillion in 2015.
By Jeff Byers • July 13, 2016 -
With New York's greenlight, Aetna/Humana merger has 90% states approval
Most of the necessary state regulators support the deal -- but the feds remain the big question.
By Heather Caspi • July 13, 2016 -
Deep Dive
Will risk-adjustment payments be the end for co-ops?
The program seems to be having a domino effect on the remaining carriers created under the ACA.
By Julie Henry • July 13, 2016 -
Struggling ACA co-op Land of Lincoln to liquidate
The Illinois insurer had about 50,000 policyholders.
By Jeff Byers • July 13, 2016 -
CMS pushes back against 'misleading' analyses of ACA plan costs
ACA plan deductibles are more affordable -- and less relevant -- than they appear, according to the agency.
By Heather Caspi • July 13, 2016 -
High cost claimants key to controlling healthcare spending
This group forms the top health cost driver for 43% of large employers.
By Heather Caspi • July 12, 2016 -
DOJ's spectre looms over falling Humana stock
On Monday, Humana's stock price fell to $154 per share; it was trading near $190 a share on June 21.
By Jeff Byers • July 11, 2016 -
President Obama calls on Congress to 'revisit' public option
The idea of a public option is back in vogue this week as Hillary Clinton's recently released health plan includes such an idea.
By Jeff Byers • July 11, 2016 -
Deep Dive
Interoperability is a four-letter word: Inching toward true exchange
The systems may need to talk to each other but the industry needs to engage the same conversation. ONC's Dr. Vindell Washington, athenahealth's Jonathan Bush, and AMA's Steven Stack weigh in.
By Jeff Byers • July 11, 2016 -
Illinois co-op to feds: We'll pay if you pay
Can the insurer strike a deal to offset its risk-adjustment bill by what it's owed under risk adjustment?
By Heather Caspi • July 11, 2016 -
Oregon co-op forced to shut down this month
About 20,600 individuals will need to find a new health plan by August 1.
By Jeff Byers • July 11, 2016 -
Aetna talks divestitures with DOJ for Humana deal
Can the potential sale of billions in assets save the merger?
By Heather Caspi • July 11, 2016 -
CMS' updated Physician Fee Schedule proposal sweeps across the continuum
The agency is updating a host of payments including some related to mental health services, diabetes prevention and care coordination.
By Meg Bryant • July 8, 2016 -
Alabama ends enhanced payments for some doctors
The payment cuts are in response to an $85 million budget gap in Medicaid funding.
By Meg Bryant • July 8, 2016 -
CMS proposes site-neutral outpatient payment rates, flexibility in EHR program
The American Hospital Association is not happy with the decision over the proposed rule.
By Heather Caspi • July 7, 2016 -
CBO: Murphy's mental health bill would trim Medicaid spending by $5M over 10 years
The House could vote on the Helping Families in Mental Health Crisis Act as early as today.
By Meg Bryant • July 6, 2016 -
Business agility key to surviving in today's fast-paced marketplace
Despite technological advances, communication remains a key challenge in managing a project team, a recent survey shows.
By Meg Bryant • July 6, 2016 -
Insurers move toward broader coverage of Hep C drugs
Restrictive policies are going by the wayside as legal fights conclude cost is insufficent reason to withhold a cure.
By Heather Caspi • July 6, 2016 -
UnitedHealth fight highlights third-party payment question
UnitedHealth says American Renal Associates' billing strategy amounts to fraud.
By Heather Caspi • July 6, 2016 -
Connecticut co-op toppled by latest risk-adjustment mandate
An obligation to pay $13.4 million into the federal risk adjustment program was the tipping point for HealthyCT.
By Heather Caspi • July 6, 2016 -
Wyoming ACA enrollment continues upward
Some, but not all of the new enrollment is attributed to layoffs around the state.
By Heather Caspi • July 5, 2016 -
Deep Dive
CMS' ACA premium stabilization data reveals gains, losses for small insurers
As of now, CMS estimates the reinsurance program will pay out around $7.8 billion to 497 insurers nationwide.
By Julie Henry • July 5, 2016
Previous
