Payer: Page 172
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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 -
Amateria1121 [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons
Oregon approves final 'mostly unchanged' 2017 premium hikes
Rate increases will be in the double digits, and some plans won't be back.
By Heather Caspi • July 5, 2016 -
Risk adjustment continues to slam small insurers
Several co-ops are among those slated to pay tens of millions into the program.
By Heather Caspi • July 5, 2016 -
Montgomery County Planning Commission
Aetna sells MA assets to mitigate antitrust concerns over Humana merger
The move comes as a strategy to help ease antitrust concerns with the health insurance giant's pending $37 billion acquisition.
By Ana Mulero • July 5, 2016 -
South Carolina officials debate potential for ACA market collapse
Severely limited marketplace offerings are negating much of the intent of the ACA, some say.
By Heather Caspi • July 5, 2016 -
ACA plan drop-outs a 'tad higher' than expected
Officials had hoped to stem the losses by targeting problematic applications for attention.
By Heather Caspi • July 5, 2016 -
Deep Dive
How insurers use gamification for customer wellness
Interactive tools, such as gaming, can make payer products more attractive to consumers and motivate customers to adopt healthy habits.
By Julie Henry • July 5, 2016 -
Merger opponents prepared to play long game
Even if the insurance industry's top players can't merge together, opponents will be watching their next moves.
By Heather Caspi • July 5, 2016 -
Open Payments data reveal docs received $7.52B industry payments in 2015
The American Medical Association chided CMS for “continued data errors and registration challenges” in its program.
By Meg Bryant • July 1, 2016 -
Why Catholic Health is bowing out of the insurance field
In the first nine months of fiscal 2016, CHI’s QualChoice subsidiary lost $97 million.
By Meg Bryant • July 1, 2016
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