Payer: Page
-
Aetna to leave 536 individual markets in major ACA exchange withdrawal
The insurer is doubling down on reversing expansion plans in the individual market.
By Jeff Byers • Aug. 15, 2016 -
New York announces ACA plan enrollment total of 2.8 million
The state credits its new Essential Plan for much of its 2016 enrollment growth.
By Heather Caspi • Aug. 15, 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 -
Anthem/Cigna merger under the gun with antitrust ruling expected in January 2017
It will be down to the wire and a hair behind the Aetna/Humana merger trial.
By Heather Caspi • Aug. 15, 2016 -
Shut it down: Blue Shield of California plans 4-day closure to help save $4M
The insurer is hoping to offset its ACA exchange losses.
By Heather Caspi • Aug. 15, 2016 -
From the frying pan to the fire: New Mexico insurance exchange CEO to call Molina new home
Amy Dowd is moving on after two years at beWellnm.
By Heather Caspi • Aug. 15, 2016 -
Math gaffe could cost Massachusetts hospitals $110M in Medicare funds
Rhode Island hospitals stand to lose $7 million, thanks to Massachusetts’ mistake.
By Meg Bryant • Aug. 12, 2016 -
New HHS data suggest risk pools are stabilizing but insurers stay skeptical
A CMS official suggests a new rule could be coming to help strengthen the ACA markets.
By Meg Bryant & Jeff Byers • Aug. 12, 2016 -
Court adopts Aetna/Humana-DOJ antitrust case schedule
The trial will last 13 days begining on December 5 and ending on December 21 - only 10 days before the insurers' contractual deadline.
By Ana Mulero • Aug. 12, 2016 -
Performance pressures cause hospitals to deny risky transplants
In the first five years since the government set organ transplant standards, more than 4,300 candidates were dropped from waiting lists.
By Meg Bryant • Aug. 12, 2016 -
Qui tam lawsuit to proceed against 5 Medicare Advantage participants
The lawsuit accuses UnitedHealthcare, Aetna and three other companies of submitting false certifications for Medicare Advantage payments.
By Meg Bryant • Aug. 12, 2016 -
ACO's integration of behavioral health yields 13% decrease in ED visits, study finds
The program at UCLA Health is showing strong results nearly three years in.
By Heather Caspi • Aug. 11, 2016 -
CMS refines upcoming value-based Medicare Advantage model
Changes are in store for the second year of the program in 2018.
By Heather Caspi • Aug. 11, 2016 -
Telehealth shines in new employer healthcare benefits analysis for 2017
The National Business Group on Health estimates overall employee health benefit costs will rise 6% next year. Many insurers have been proposing double-digit premium rate increases for the ACA exchanges in 2017.
By Meg Bryant • Aug. 10, 2016 -
Bending of Medicare cost curve projected to save $2 trillion
The massive spending reduction indicates the long term viability of Medicare, the study suggests.
By Heather Caspi • Aug. 10, 2016 -
Deep Dive
Increase in parity supports building out mental health informatics
The lack of robust, standardized data fields for behavioral health could be an opportunity for health IT vendors.
By Jeff Byers • Aug. 10, 2016 -
Aetna/Humana-DOJ antitrust trial date set for December
The date is later than the insurers were requesting.
By Jeff Byers • Aug. 10, 2016 -
Study findings fuel debate over whether Medicare Advantage offers better care at a lower cost
Medicare Advantage plans pay hospitals an average of 5.6% less for services than fee-for-service Medicare, according to a recent analysis.
By Heather Caspi • Aug. 10, 2016 -
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