Payer: Page 181
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BCBSA study highlights savings of outpatient care
In addition to costing less, outpatient care can achieve similar or better results, the study says.
By Heather Caspi • Feb. 25, 2016 -
Tenet near settlement on Georgia kickback charges, posts 2015 Q4 loss
While uncompensated care grew overall, Tenet’s six Medicaid expansion states saw a drop in uninsured admissions.
By Meg Bryant • Feb. 24, 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 -
After receiving $12.5M last year, this health benefits startup laid off 25% of its staff
The company raised the cash in venture capital funding last year but is looking to stay lean during tough times.
By Meg Bryant • Feb. 24, 2016 -
Coming this spring: CMS' MIPS payment model details
CMS is investing $650 million to help more than 140,000 physicians make the shift to a value-based payment model.
By Meg Bryant • Feb. 24, 2016 -
Oscar gets estimated $2.7B value after $400M Fidelity fiscal infusion
Some suggest the large investment provides validation for the insurer in light of the recent collapse in tech valuations.
By Heather Caspi • Feb. 24, 2016 -
California health plan tax supporters optimistic
Legislation that would expand a tax on health plans could be decided this week.
By Heather Caspi • Feb. 24, 2016 -
Wyoming, Maine see further efforts toward Medicaid expansion
Supporters in each state hope the next attempt will be the charm.
By Heather Caspi • Feb. 24, 2016 -
Deep Dive
Study challenges Medicare payment differential for outpatient settings
Does it make sense for physician offices to get a different rate than off-campus hospital outpatient departments?
By Heather Caspi • Feb. 23, 2016 -
Downplayed merger meeting hints at deals among BCBS insurers
Will the cycle of industry consolidation push some of the Blue plans into a deal?
By Heather Caspi • Feb. 23, 2016 -
Deep Dive
Cash discounts for bypassing insurance stirs up debate, administrative unease
The process may provide a short-term gain for all involved, but could it hurt in the long run?
By Heather Caspi • Feb. 22, 2016 -
CMS sends overhauled Medicaid 'uber rule' to OMB
The "uber rule," which upgrades Medicaid managed care for the first time in over 10 years, could be published in May, a full year after its proposal.
By Heather Caspi • Feb. 22, 2016 -
UPMC claims to bump Highmark as top Western Pa. insurer
If the finding is true, it has good and bad implications for both parties.
By Heather Caspi • Feb. 22, 2016 -
51 hospitals reach $23M settlement as DOJ concludes cardiac device investigation
A whistleblower alleged the hospitals implanted cardiac devices in elderly patients in violation of Medicare coverage requirements.
By Meg Bryant • Feb. 19, 2016 -
California slow to warm up to Oscar
Oscar’s slow start in California illustrates the difficulty competing with market strongholds like Anthem and Blue Shield.
By Meg Bryant • Feb. 19, 2016 -
Why Covered California could become first in the U.S. to set commissions for ACA signups
The exchange feels such rules are needed to ensure health plans don’t use commissions as a way of avoiding sicker, more costly consumers.
By Meg Bryant • Feb. 19, 2016 -
CMS' proposed Medicare Advantage 2017 rates spark insurer shares boost
Insurer shares rose after CMS released its 2017 proposed Medicare Advantage rates, signaling good news for carriers.
By Jeff Byers & Shalina Chatlani • Feb. 19, 2016 -
Deep Dive
It took CMS four years to finalize its 60-day overpayment rule. Here's how the industry is reacting.
CMS estimates the administrative costs of the final rule at more than $1.3 billion over the next 10 years.
By Nina Flanagan • Feb. 19, 2016 -
Industry leaders propose 6 healthcare reforms
The group is lobbying congressional leaders for bipartisan support of its six "common-sense" solutions.
By Heather Caspi • Feb. 18, 2016 -
Alabama approved for move to Medicaid managed care
The state could receive up to $748 million in federal funding to support the effort.
By Heather Caspi • Feb. 18, 2016 -
Study connects wellness programs to stock performance
Companies that invest in wellness may be more likely to outperform the S&P 500.
By Heather Caspi • Feb. 18, 2016 -
Aetna/Humana secure another approval, but hurdles remain
Aetna/Humana has secured 10 of the 20 needed state approvals but Florida's approval comes with strings attached.
By Heather Caspi • Feb. 17, 2016 -
Medicare Advantage sign-ups soar despite spending cuts
The program has several advantages over the ACA marketplaces, experts say.
By Heather Caspi • Feb. 17, 2016 -
California considers massive health plan tax hike
The state appears on the brink of passing a new tax more encompassing than the one it would replace.
By Heather Caspi • Feb. 17, 2016 -
Deep Dive
The possibility is 'quite real.' Experts weigh in whether big payers will exit ACA exchanges
If insurers' financial losses continue through 2016, the marketplace landscape could look different next year.
By Heather Caspi • Feb. 17, 2016 -
Kaiser membership up but net income down
The company's net income was down more than a billion from 2014.
By Heather Caspi • Feb. 16, 2016
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