Payer: Page 169
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Medicaid expansion good for states' bottom lines, study says
Participating states are seeing net budgetary gains despite some increased spending on their Medicare programs.
By Heather Caspi • Aug. 9, 2016 -
Connecticut exchange coverage could take hits over threat of dwindling broker commissions
If commissions go, brokers are set to leave as well.
By Heather Caspi • Aug. 9, 2016 -
ACA squashed formation of physician-owned hospitals, study finds
Restrictions on new POHs have rendered them non-viable, researchers say.
By Heather Caspi • Aug. 9, 2016 -
The last major insurer on Alabama ACA market is seeking an average 39% individual premium hike
The proposed rates could affect more than 160,000 individuals.
By Jeff Byers • Aug. 8, 2016 -
Harken Health withdraws from ACA expansion plans into South Florida
While reasons behind the reversal are currently unknown, Harken Health will instead plan to expand the number of its primary care clinics in Atlanta and Georgia.
By Ana Mulero • Aug. 8, 2016 -
Medicaid expansion leads to better healthcare outcomes, study finds
Adopting expansion was associated with an increase of access to primary care by 12.1 percentage points.
By Ana Mulero • Aug. 8, 2016 -
Moving on up: New York releases approved health insurance rates for 2017
Only four of the 17 companies listed had an approved premium percentage increase under double-digits.
By Jeff Byers • Aug. 6, 2016 -
Cigna preps Plan B in face of potential Anthem merger dissolution
By the first half of 2017, Cigna could potentially have $5 billion to play with and explore share buybacks or different acquisitions.
By Jeff Byers • Aug. 6, 2016 -
DC judge shuffles megamerger cases, hands off Anthem/Cigna suit
Anthem's case was reassigned to U.S. District Judge Amy Berman Jackson, court filings show.
By Ana Mulero • Aug. 5, 2016 -
NY's MVP Health Care seeks bigger footprint in Medicaid market
Managed care has been at the forefront of New York’s Medicaid population growth since the state expanded eligibility under the ACA.
By Meg Bryant • Aug. 5, 2016 -
UnitedHealth doles out $148 in value-based bonuses to docs
Over the past three years, UnitedHealthcare has paid out $48 billion to providers.
By Meg Bryant • Aug. 5, 2016 -
UnitedHealth appeals loss of $58B Tricare contract collection
If GAO agrees with UnitedHealth, the Department of Defense could reopen bidding or reconsider UnitedHealth’s proposals.
By Meg Bryant • Aug. 5, 2016 -
Aetna is also urging DOJ for speedy trial over pending Humana merger
While Aetna and Anthem are pushing for quick, separate trials over their megamergers, the Justice Department says it could be ready for trial as soon as February 17, 2017.
By Ana Mulero • Aug. 3, 2016 -
This may hurt a little: Readmission penalties expected to reach new record for hospitals
More than half a billion dollars in payments will be withheld from hospitals when the new penalties take effect in October.
By Ana Mulero • Aug. 3, 2016 -
Deep Dive
What the new mandatory bundled payments for cardiac care could mean for the industry
One expert believes the industry can expect to see similar models on the horizon for oncology and maternity care.
By Julie Henry • Aug. 3, 2016 -
Humana outlines ACA market withdrawal in Q2 earnings report
The carrier stated it's pulling back individual market operations to "no more than 156 counties" in 11 states.
By Jeff Byers • Aug. 3, 2016 -
CMS final rule 'permanently' removes controversial two-midnight payment cut
All in all, the agency estimated that total Medicare spending on inpatient hospital services will increase by about $746 million in FY 2017.
By Jeff Byers • Aug. 2, 2016 -
Appeals court: Maryland health co-op must make $24M risk adjustment payment
The co-op is optimistic it will be able to settle the balance.
By Ana Mulero • Aug. 2, 2016 -
Deep Dive
Consolidation in healthcare continues, but nontraditional alliances are also on the rise
More healthcare companies are looking to partner with organizations, rather than purchase them outright, an expert says.
By Meg Bryant • Aug. 2, 2016 -
Montgomery County Planning Commission
Aetna rethinks its ACA exchange strategy
The insurer, which plans to sell Medicare Advantage assets to Molina Healthcare, hopes the deal will ease antitrust concerns over the pending Humana merger.
By Jeff Byers • Aug. 2, 2016 -
New insurance data analysis shows how large the opioid epidemic is
Fair Health's analysis of claims data spanning 105 million individuals found medical services on an insurance claim with an opioid dependence diagnosis rose 3,203% from 2007 to 2014.
By Jeff Byers • Aug. 1, 2016 -
These 14 regions have been selected for CPC+
Practices can now apply to participate in the gamechanging primary care model.
By Jeff Byers • Aug. 1, 2016 -
Why DOJ is pushing against Anthem's speedy trial request over Cigna merger
Anthem hoped to meet its April target acquisition date by getting the trial over with.
By Heather Caspi • Aug. 1, 2016 -
Hospice, rehab, skilled-nursing facilities to face payment changes under 2017 Medicare rates
Payments will increase and new quality measures will be adopted once CMS' final rules become effective on October 1.
By Ana Mulero • Aug. 1, 2016 -
How to regulate insurance network adequacy?
Narrow health plan networks may offer consumers value, but they also pose risks.
By Meg Bryant • July 29, 2016
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