Payer: Page
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Global analysis rates US 'moderate' in progress toward value-based healthcare
Points from the report could shed light on the path forward for the U.S.
By Heather Caspi • Sept. 22, 2016 -
Montgomery County Planning Commission
Aetna, others appeal PA's estimated $5B Medicaid contract awards
Managed-care companies continue to vie for the contracts worth $5.4 billion in annual revenue.
By Heather Caspi • Sept. 21, 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 -
ACO inside report details challenges of 'regulatory headwinds'
Regulatory "tweaks" could determine whether providers stay with the MSSP over the long haul, Aledade contends.
By Heather Caspi • Sept. 21, 2016 -
Deep Dive
MACRA is coming: A quick once-over before the final rule
MACRA is set to make significant changes to provider payments and reporting requirements. Will these changes be effective and will providers even notice?
By Luke Gale • Sept. 21, 2016 -
AHIP mobilizes industry opposition to public option
Though there is no imminent threat, support for the concept has leaped forward.
By Heather Caspi • Sept. 21, 2016 -
NAHC pays $30M to settle improper billing charges
The false billings were submitted to Medicare and TRICARE for unnecessary rehab services.
By Meg Bryant • Sept. 20, 2016 -
Study highlights relative affordability of ACA vs. employer premiums
The findings provide perspective to frame concerns over premium increases in the ACA marketplaces.
By Heather Caspi • Sept. 20, 2016 -
CMS bundled payment evaluation 'encouraging' yet inconclusive
Only time – and more data – will tell what the true savings and quality impacts will be.
By Heather Caspi • Sept. 20, 2016 -
North Carolina levies record fine against BCBS over IT fiasco
Despite the size of the fine, it pales in comparison to the insurer's other expenses in cleaning up its mess.
By Heather Caspi • Sept. 19, 2016 -
Aetna claims confidence during merger trial preparation
The health insurance giant believes it has a strong case but it is preparing for the decision to go either way.
By Heather Caspi • Sept. 19, 2016 -
Centene plans to expand participation in Arizona exchange
The insurer may be the only one offering health plans on the ACA exchange in Maricopa County next year.
By Luke Gale • Sept. 16, 2016 -
GOP Senate proposal addresses lack of options on exchanges
There are dueling ideas on the Senate floor for dealing with lack of competition on the insurance exchanges.
By Luke Gale • Sept. 16, 2016 -
Employers shift costs with 12% surge in deductibles
The move has helped hold down premiums, but at what other expense?
By Heather Caspi • Sept. 15, 2016 -
House committees detail harsh co-op, marketplace lessons learned
While the marketplace may be on course for a correction, it's less certain whether any co-ops will remain to participate.
By Heather Caspi • Sept. 15, 2016 -
Census: ACA adds an assist to insure more Americans
The percentage of uninsured Americans dipped from 2014 to 2015 to a total of 9.1% of the population under age 65.
By Heather Caspi • Sept. 14, 2016 -
GAO details fraud, satisfaction in marketplace performance reports
Room for improvement remains in the areas of fraud prevention and consumer satisfaction.
By Heather Caspi • Sept. 14, 2016 -
CMS: Nearly all states reduced preventable hospital readmissions
Vermont was the only state where the rate increased in 2015.
By Ana Mulero • Sept. 14, 2016 -
Study: Patients with consumer-driven health plans pay more, consume less
Total spending on patients with consumer-driven health plans is lower than average, but patients pay much more out-of-pocket.
By Luke Gale • Sept. 14, 2016 -
Aetna's Bertolini counters accusation of power play against DOJ
The company did not present antitrust officials with an ultimatum, just "reality," its CEO says.
By Heather Caspi • Sept. 14, 2016 -
HHS risk corridors update invites insurer litigation
Legal action may be insurers' best bet for recovering unpaid funds owed to them under the program.
By Heather Caspi • Sept. 13, 2016 -
Risk adjustment debt of $46M forces another co-op to drop
Health Republic Insurance of New Jersey's exit will reduce options for ACA coverage from five this year to only two in the state.
By Ana Mulero • Sept. 13, 2016 -
Help: Obama looks to insurers for upcoming ACA marketplace enrollment period
The president met on Monday with the heads of select insurance companies to discuss ACA marketplace participation, stabilization.
By Jeff Byers • Sept. 13, 2016 -
Oscar names new chief medical officer in midst of strategy adjustment
Shaden Marzouk enters as the company looks toward its own health center and a slashed provider network.
By Heather Caspi • Sept. 13, 2016 -
Waterborne infection hospitalizations for Medicare beneficiaries may reach $2 billion
Hospitals that provided treatment for three studied infections received a total of $9 billion from 1991 through 2006.
By Ana Mulero • Sept. 12, 2016 -
Aetna faces probe over 'politically motivated' Obamacare exit
The company is accused of trying to force DOJ antitrust regulators to accept its merger with Humana.
By Heather Caspi • Sept. 12, 2016
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