UnitedHealthcare still out from Tricare after appeal

The nation's largest insurer has lost its lucrative role serving the military's Tricare system.

By Heather Caspi • Nov. 17, 2016

Recognizing and preventing medical device fraud

“The medical device area is particularly susceptible to kickbacks for physicians,” says Arnall Golden Gregory partner and former Justice Department attorney Sara Lord.

By Meg Bryant • Nov. 17, 2016

Explore the 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

ACA market enrollment hits 1M in midst of repeal threat

Despite the uncertainty around Obamacare – or perhaps because of it – consumers have flocked to HealthCare.gov.

By Heather Caspi • Nov. 17, 2016

Hospital consolidation drives increases in private payer rates, MedPAC finds

The gap between reimbursement rates set by private payers and by Medicare is growing.   

By Luke Gale • Nov. 17, 2016

9 ways hospitals can reduce debt

Many hospitals and health systems don’t have a complete handle on what their costs of care are and they’re losing money as a result, says BDO Consulting’s Patrick Pilch.

By Meg Bryant • Nov. 16, 2016

Anthem, DOJ prep battle plans for next week's merger trial

The DOJ suggests the deal is illegal regardless of what its impacts might be.

By Heather Caspi • Nov. 16, 2016

Obama challenges GOP to do better on healthcare

The outgoing president said he'll be the first to congratulate the GOP if they can improve on the ACA.

By Heather Caspi • Nov. 16, 2016

Who will be the next HHS secretary? Reader reactions, questions for a Trump presidency

Many readers want to see more policy details for Trump's healthcare proposals.

By Jeff Byers • Nov. 16, 2016

Watch: ACEP parodies Cigna ad to highlight fair emergency care coverage issue

"Many people don't realize how little insurance coverage they have until they visit the ER, and then they are shocked at how little their insurance company pays," ACEP President Rebecca Parker stated.

By Luke Gale • Nov. 16, 2016

Diving into the MIPS timeline, performance categories & scoring

Around 600,000 providers will be affected by the new reporting requirements. 

By Luke Gale • Nov. 16, 2016

States eye tweaks to Medicaid expansion as they await GOP policy

Stakeholders are betting the new administration will put more power in states' hands to design their own programs.

By Heather Caspi • Nov. 16, 2016

Court rejects Illinois co-op's 'risk corridor' lawsuit

The decision could be a sign of how similar lawsuits may fare.

By Meg Bryant • Nov. 15, 2016

HHS Secretary Burwell: Obamacare 'now woven into the fabric of our nation'

The head of HHS provided an inside perspective on the potential demise of the ACA.

By Heather Caspi • Nov. 15, 2016

Cerner looking to branch out with genomics testing

Eighty-two Cerner employees have volunteered their DNA profiles for the company's pilot program that aims to prevent illnesses or reduce their effects.

By Meg Bryant • Nov. 15, 2016

Paul Ryan sets sights on Medicare as part of ACA fight

The House Speaker is attempting to lump the programs together in a single healthcare overhaul.

By Heather Caspi • Nov. 15, 2016

Collision of ACA repeal plans, open enrollment add urgency to insurance uncertainty

Conflicting messages are coming as the Obama administration continues to push ACA signups during its final months.

By Heather Caspi • Nov. 14, 2016

ACA repeal considerations stump states that expanded Medicaid

Officials in some Medicaid expansion states have vowed to work with the Trump administration to maintain coverage levels.

By Meg Bryant • Nov. 11, 2016

Study: Multisector partnerships lower death rates in communities

Fragmented delivery and financing systems for public health and social services have limited the effectiveness of population health efforts, the University of Kentucky researchers say.

By Meg Bryant • Nov. 11, 2016

Lawmaker seeks answers to CMS' delay on EpiPen Medicaid rebate dodge

The Senate Judiciary Committee has scheduled a Nov. 30 hearing to discuss Mylan’s settlement with the Department of Justice.

By Meg Bryant • Nov. 10, 2016

How the GOP could try to repeal or change the ACA

Numerous health organizations took forward-looking stances Wednesday that suggested advancements toward value-based care may be here to stay, ACA or no ACA.

By Heather Caspi • Nov. 9, 2016

Trump victory spells tough times ahead for ACA

Some healthcare stocks didn't take the win well.

By Jeff Byers • Nov. 9, 2016

Enrollment activity already straining Healthcare.gov

Many customers have been in for a virtual wait before being able to process an application.

By Heather Caspi • Nov. 9, 2016

BCBSA joins FDA initiative to speed up medical device approvals

The agency created a task force to speed up approvals by allowing pre-submission meetings to help design clinical trials that meet regulatory and medical coverage requirements. 

By Luke Gale • Nov. 9, 2016

Ryan accepts ACA here to stay – if Clinton wins

The conservative war against Obamacare could soon wane, if Ryan has anything to say about it.

By Heather Caspi • Nov. 8, 2016

Highmark rocks Pennsylvania with massive marketplace pullback

The insurer will withdraw from more than half the counties where it participated this year.

By Heather Caspi • Nov. 7, 2016