Payer: Page 169
-
Oscar attempts to hem ACA losses by expanding into provider territory
The health insurance darling is looking for a medical director and primary care physician for a member-exclusive health center.
By Heather Caspi • June 20, 2016 -
Patient's healthcare spending patterns established long before last months
A new study in Health Affairs shares insights into end-of-life care costs.
By Heather Caspi • June 20, 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 -
Long-awaited CMS final rule updates clinical lab tests payments
Private rates will form the basis for most updates, the agency announced. Some say the impact could be substantial.
By Heather Caspi • June 20, 2016 -
Montgomery County Planning Commission
Aetna sues Nebraska over Medicaid contract loss
Aetna wants a continued share of Nebraska’s nearly $1 billion Medicaid market.
By Meg Bryant • June 17, 2016 -
Florida Blues reports $471M profit on 2015 ACA plans
The insurer is requesting a premium hike of nearly 10% despite its marketplace success.
By Heather Caspi • June 16, 2016 -
Popular ACA plans' premiums projected to increase by 10%
While it's still early in the rate process, complete proposals are available in 14 cities.
By Heather Caspi • June 16, 2016 -
CA insurance commissioner pleads to DOJ to block Anthem/Cigna
Dave Jones contends that the merger would highly reduce competition in the state, where three insurers constitute 75% of the insurance market.
By Jeff Byers • June 16, 2016 -
Slavitt shares 3 tips to improve value-based payments
CMS wants to give practices more flexibility to adapt the Quality Payment Program to their unique needs and make adjustments over time.
By Meg Bryant • June 15, 2016 -
CMS puts up $32M to target kids' enrollment in federal health programs
The Obama adminstration is continuing its efforts to get as many eligible children covered as possible.
By Heather Caspi • June 15, 2016 -
MedPAC proposals could bring reforms to Medicare Part D program
If implemented, the changes could bring both pros and cons for beneficiaries.
By Heather Caspi • June 15, 2016 -
Enough is enough: Maryland co-op sues feds over risk adjustment flaws
Evergreen wants to end the advantage of large insurers over small.
By Heather Caspi • June 15, 2016 -
Lack of patient data, quality measures slowing shift to value-based care
Only 33% of physicians believe the U.S. healthcare system should be value-based, according to a new study.
By Meg Bryant • June 15, 2016 -
ACA repeal would cause 53.5M to be uninsured, study finds
Employer-sponsored coverage is expected to decrease regardless of the presence of the ACA due to the costs of healthcare outpacing income.
By Heather Caspi • June 14, 2016 -
Deep DiveAntibiotic resistance: Can the clock be turned back?
For years, doctors took a “better safe than sorry” approach to antibiotics. That may be wrong, a CDC official posits.
By Meg Bryant • June 14, 2016 -
UnitedHealthcare to reimburse kidney donors up to $5K for travel, lodging
The move aims to reduce one of the financial barriers people face in becoming living donors.
By Heather Caspi • June 14, 2016 -
Deep Dive
You can't do that in healthcare: Antitrust compliance paramount in avoiding patient-steering suits
In light of the recent Carolinas HealthCare System antitrust suit, "the way things have always been done" is not sufficient to protect a provider from government investigations or civil suits.
By Julie Henry • June 14, 2016 -
Sebelius voices concern over pending insurance mergers
The former HHS secretary sees reduced competition as a threat to the intent of the ACA.
By Heather Caspi • June 13, 2016 -
Alex Wong via Getty Images
Deep DiveStudies tout progress toward value-based reimbursement
In a recent survey commissioned by McKesson, payers estimated nearly 60% of payments will be a mix of capitation/global payments, pay for performance, and bundled payments in five years.
By Jeff Byers • June 13, 2016 -
Health discrimination, antibiotic overuse on the chopping block in new CMS proposed rule
The agency estimates new antibiotic overuse reduction policies will save hospitals up to $284 million annually.
By Jeff Byers • June 13, 2016 -
HHS: ACA bumped health coverage in rural counties up 8%
While touting the progress achieved so far in rural communities, the agency argued more could be made if more states choose to expand Medicaid.
By Heather Caspi • June 13, 2016 -
Deep Dive
CMS' final rule on ACO benchmarks receives mixed reactions
One response claimed comparing ACOs to one another for benchmarking is against the original intent of the program.
By Julie Henry • June 13, 2016 -
Aetna touts smooth integration efforts with Humana
The pair are projecting a cool that contrasts with the contentious communication between the merger behind Anthem and Cigna.
By Heather Caspi • June 13, 2016 -
DOJ slams NC's biggest hospital chain with patient steering lawsuit
The lawyer representing Carolinas Healthcare System said, “The system is being sued for something that takes place on a regular basis across the country."
By Meg Bryant • June 10, 2016 -
CMS' Slavitt: Lessons learned during ACA market's experimentation phase
The agency's acting administrator encouraged insurers to partner with hospital systems that have seen significant benefits from the ACA to reduce costs for consumers.
By Ana Mulero • June 10, 2016 -
New limits on short-term plans lead HHS efforts to strengthen ACA risk pool
A proposed rule would halt the trend of limited plans being used in lieu of full coverage.
By Heather Caspi • June 9, 2016
Previous
