Payer: Page 176
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Thinking of starting a provider-led health plan? Ask these four questions
In a recent analysis, 40 of 89 provider-led health plans had negative margins during the past three years.
By Meg Bryant • April 15, 2016 -
Elizabeth Regan/Healthcare Dive
ACOs show modest savings in first full year
Organizations in the Medicare Shared Savings Program were able to maintain or improve certain care performance measures.
By Meg Bryant • April 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 -
Individual market to look up after 2017, analysts predict
In 2014, insurers lost about $3 billion in the marketspace but it could become more viable as insurers gain experience pricing their products.
By Heather Caspi • April 14, 2016 -
HHS report debunks fear of a double-digit Obamacare premium increase
As 67% of HealthCare.gov consumers opted for a new plan in 2016, HHS states premiums depend on market dynamics as a whole, not just payer pricing decisions.
By Meg Bryant • April 13, 2016 -
Insurers' experience all over the map during first ACA risk adjustment year
An analysis by the American Academy of Actuaries states premiums need to reflect the level of risk in an entire market pool, not just insurers' beneficiaries.
By Meg Bryant • April 13, 2016 -
Deep Dive
Insurers take on obesity prevention
Many insurers are going above and beyond with both local and national obesity prevention efforts.
By Julie Henry • April 13, 2016 -
Humana flub tells 12K people their drugs not FDA approved
The incident impacted a portion of Humana's Texas enrollees.
By Heather Caspi • April 13, 2016 -
Health insurers pay for obesity -- one way or another, experts say
The cost of denying obesity care could exceed that of providing it, experts say.
By Heather Caspi • April 13, 2016 -
Short-term health policy sales surge despite plan limitations
Those who develop health problems can always switch to a ACA plan to cover pre-existing conditions, insiders note.
By Nina Flanagan • April 12, 2016 -
Deep Dive
How the disruptive insurer Harken Health is tackling the Illinois, Georgia markets
The insurer is optimistic after opening its primary care sites in Chicago and Atlanta.
By Nina Flanagan • April 12, 2016 -
Florida, California take on surprise medical bills
Two more states are pursuing legislation akin to that established in New York.
By Heather Caspi • April 12, 2016 -
New York expects to enroll 470,000 in low-cost health plan
The state is targeting its remaining uninsured with this new option available under the Affordable Care Act.
By Heather Caspi • April 12, 2016 -
Covered California first state exchange to set quality, cost standards for health plans
The organization will exclude providers offering low-quality or over-priced care from plan networks as soon as 2019.
By Heather Caspi • April 11, 2016 -
Majority of Americans say healthcare price, quality not connected
Perceptions of a price/quality connection could impact the movements toward transparency and price shopping.
By Heather Caspi • April 11, 2016 -
GAO report highlights ACA state exchange security flaws
Hundreds of thousands of users' data were vulnerable to hackers in California, Kentucky and Vermont's exchange websites.
By Heather Caspi • April 11, 2016 -
New CMS payment model largest multi-payer initiative to date, could include 20K doctors
The Comprehensive Primary Care Plus model seeks to give providers freedom to deliver care that best meets patients' needs.
By Jeff Byers • April 11, 2016 -
UnitedHealth leaving Georgia, Arkansas ACA markets
The largest insurer in America hasn't stated whether or not it will leave additional state markets.
By Jeff Byers • April 8, 2016 -
CMS releases final 2017 summary of benefits and coverage template
The new SBC includes a coverage example for a simple fracture and information on cost-sharing and hyperlinking capabilities.
By Meg Bryant • April 8, 2016 -
Tenet leaves S&P's 500 index, joins MidCap 400
Beauty store chain Ulta Salon, Cosmetics & Fragrance will take the corporation's place.
By Ana Mulero • April 8, 2016 -
Former UnitedHealthcare CEO raises $80M for payer startup
Bright Health is betting digital health is on their side as they wade into the murky waters of establishing an insurance business.
By Nina Flanagan • April 7, 2016 -
Aetna pays employees up to $500 per year to sleep
The insurer argues the investment pays back in worker productivity and improved decision-making.
By Heather Caspi • April 7, 2016 -
Study identifies top 3 price-shopped procedures
The biggest issue remains getting people to price shop in the first place, researchers say.
By Heather Caspi • April 6, 2016 -
Report calls on IRS to tap data to find uninsured
Federal officials have the capacity to find many of the uninsured--if they want to, researchers say.
By Heather Caspi • April 6, 2016 -
Employer-based coverage surprisingly stable post-ACA
Large employers are likely to continue to provide coverage for the next 10 years, the CBO estimates.
By Heather Caspi • April 6, 2016 -
Deep Dive
What happens if Obamacare is repealed?
It's possible the ACA could be repealed or amended.
By Julie Henry • April 6, 2016
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