Payer: Page 176
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More docs paid for value-base care, but far from majority
Traditional fee-for-service care still dominates the southwestern U.S., driving costs up in that region.
By Meg Bryant • June 8, 2016 -
Connecticut admin refuses to provide records about Anthem/Cigna merger
The rejection comes a day after Anthem requested an average 26.8% premium increase for its individual plans.
By Ana Mulero • June 8, 2016 -
TV stunt thrusts medical debt into national spotlight
John Oliver's television spectacle has raised concern over medical costs and billing to a new level.
By Heather Caspi • June 7, 2016 -
Deep Dive
Video: A humorous look at 5 payer challenges and strategies for success
The fictional payer Dynamite Health Plan’s quarterly report shares some insights and laughs into insurers' operations.
By Julie Henry • June 7, 2016 -
AHIP EVP: Risk corridors necessary in healthcare
The trade group is defending the program as insurers take their claims to court.
By Heather Caspi • June 7, 2016 -
CMS puts finishing touches on incentives designed to help ACOs
A final rule revealed Monday established timeframes and other criteria to challenge CMS' initial determination of shared savings or shared losses.
By Ana Mulero • June 7, 2016 -
North Carolina, Oregon insurers latest to sue feds over risk corridors
The lawsuits are seeking timely and full payment of the money owed under the program.
By Heather Caspi & Ana Mulero • June 6, 2016 -
Far from over: Most insurers see opportunity in marketplaces, Commonwealth Fund finds
The majority of participating insurers in the ACA market plan to hold out for more profitable days ahead.
By Heather Caspi • June 6, 2016 -
California seeks to provide ACA benefits for undocumented immigrants — but will it work?
The California Assembly gave a green light for the state to apply for a federal waiver that would allow undocumented immigrants to buy health insurance through Covered California.
By Meg Bryant • June 3, 2016 -
Montgomery County Planning Commission
Aetna outlines plan to fund Humana merger
While the companies say the merger is on track to close this year, the proposal is facing stiff scrutiny from regulators.
By Meg Bryant • June 3, 2016 -
Deep Dive
Nursing scope of practice under the microscope in VA's controversial proposed rule
Whether or not advanced practice nurses should be able to practice without physician supervision has long been a hot button topic.
By Julie Henry • June 3, 2016 -
Obama admin downplays 2017 premium concerns
Recently, Blue Cross Blue Shield of Texas asked to raise rates by about 60% for its 603,000 individual policyholders.
By Meg Bryant • June 3, 2016 -
Deep Dive
How are algorithms changing healthcare?
“It’s not just about big data," says Apervita co-founder and Chief Marketing Officer Rick Halton. "It’s really small data that you’re putting into practice.”
By Meg Bryant • June 2, 2016 -
Alaska House aims to save individual market from collapse
A bill that would subsidize high risk plans now moves on to the state Senate.
By Heather Caspi • June 1, 2016 -
BlueCross subsidiary dropping bronze plans in Virginia
During 2016 open enrollment, about 23% of Obamacare enrollees opted for bronze plans, which pay about 60% of healthcare costs.
By Meg Bryant • June 1, 2016 -
UnitedHealth quits California ACA market after one year
The impact of its exit may not be huge as the insurer only has about 2,100 customers from Covered California.
By Meg Bryant • June 1, 2016 -
Insurer darling Oscar adds Arizona office to strategy in West
The insurer is counting on a ready local workforce to ramp up operations quickly.
By Heather Caspi • June 1, 2016 -
Louisiana pioneers new enrollment approach for Medicaid expansion
The state will use its existing SNAP data to determine eligibility.
By Heather Caspi • June 1, 2016 -
IRS ruling presents hurdle for ACOs
The decision will be bad news for those seeking tax-exempt status.
By Heather Caspi • June 1, 2016 -
CMS reiterates guidance barring waiting periods for benefits
Now pediatric orthodontia is included in the CMS' updated policy.
By Heather Caspi • May 31, 2016 -
Ohio ACA health co-op latest to topple; 10 remain
InHealth Mutual doesn't have the funds to carry on, the state determined.
By Heather Caspi • May 31, 2016 -
Deep Dive
Premiums set to rise as insurers lose money on Obamacare plans
HMOs and plans with narrow networks have fared better than other types of plans on the ACA market.
By Julie Henry • May 31, 2016 -
CMS allows ACOs to join the CPC+ party
The CPC+ model will be rolled out in up to 20 regions and encompass more than 20,000 providers.
By Jeff Byers • May 31, 2016 -
Startup insurer Bright Health teams with Centura on Colorado exchange
Centura will serve as the insurer's exclusive provider of choice.
By Heather Caspi • May 30, 2016 -
Aetna, Texas Health to launch integrated health plan
The firms will offer new insurance products in 14 North Texas counties beginning January 2017.
By Meg Bryant • May 27, 2016
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