Payer: Page 183
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BCBSA study finds ACA patients cost 20% more
The report finds ACA enrollees to have been higher utilizers of medical services.
By Heather Caspi • March 31, 2016 -
How a $70M healthcare fraud can get you five years in prison
Damien Mayol received a five-year prison sentence for participating in a scheme used to develop an illegal kickback operation.
By Nina Flanagan • March 31, 2016 -
CAQH Index: E-admin transactions can save healthcare industry $8 billion annually
On the provider side, automated eligibility and benefits processes could save more than $5 billion every year, the nonprofit found.
By Nina Flanagan • March 31, 2016 -
HCA hospitals, Molina battle brewing over $88M in reimbursements
The issue, surrounding out-of-network emergency care expenses, highlights a trend in narrow network health plans.
By Heather Caspi • March 30, 2016 -
Anthem/Cigna merger takes heat during hearing by California insurance commissioner
Dave Jones, the commissioner of California's Department of Insurance, has to approve or reject the pending deal.
By Nina Flanagan • March 30, 2016 -
Deep Dive
Healthcare payer mergers: Pros & cons
Consolidation in the insurance industry could allow insurers to bargain with providers on more equal terms.
By Julie Henry • March 30, 2016 -
NYC Health + Hospitals hinges financial future on EMR, growth
On the brink of a controversial new EMR launch, the city health system is working to dig its way out of a financial hole.
By Heather Caspi • March 30, 2016 -
Humana study promotes wellness program benefits, increased productivity
Participants saw their health costs go down and productivity go up, the insurer says.
By Heather Caspi • March 30, 2016 -
SCOTUS seeks additional information for compromise on 'contraceptive mandate'
The court wants not only to allow religious nonprofits to sidestep insurance coverage for contraceptives but also make sure employees receive coverage.
By Nina Flanagan • March 30, 2016 -
Hospital system courts veterans in unprecedented ad campaign
Will the private sector support or compete with the VA health system?
By Heather Caspi • March 29, 2016 -
Medicaid enrollment surpassing expectations as ACA plans lag
Government coverage is proving popular, and ACA plans...not as much.
By Heather Caspi • March 29, 2016 -
CMS final rule pushes to improve mental health access, substance use services for 23M
The rule released yesterday was designed to be closely align to a 2008 mental health parity law to promote consistency in markets.
By Ana Mulero • March 29, 2016 -
CMS to pilot new payment model for skilled nursing facilities
The agency wants to see if the new payment model helps reduce avoidable hospitalizations at long-term nursing facilities.
By Meg Bryant • March 25, 2016 -
Advocate, NorthShore's low-cost health plan aimed at allaying merger concerns
The proposed health plan would be limited to providers in the combined hospital system.
By Meg Bryant • March 25, 2016 -
Deep Dive
This Text In: One question with naviHealth's Brian Fuller
What's the most important thing hospitals should be prepping to be successful with the April 1 launch of the Comprehensive Care for Joint Replacement model?
By Jeff Byers • March 24, 2016 -
Investigators say HealthCare.gov hit with 316 security incidents
The GAO said although there was no personal information released, the website's security flaws seem to be focused around the data services hub.
By Nina Flanagan • March 24, 2016 -
Deep Dive
Telemedicine and alternative payment models: An apt fit
Will new federal regulations help make APMs and telemedicine go together like peas and carrots?
By Meg Bryant • March 24, 2016 -
CMS just got more time to justify the two-midnight payment cut
CMS maintains the 0.2% inpatient payment reduction is needed to counter an expected increase in inpatient cases under the two-midnight policy.
By Meg Bryant • March 23, 2016 -
Deep Dive
Are hybrid policies replacing long-term care insurance?
A major barrier to getting people to purchase long-term care policies continues to be a lack of education.
By Julie Henry • March 23, 2016 -
$6.8B Centene/Health Net merger receives final merger approval
It's on.
By Jeff Byers • March 22, 2016 -
Cerner completes expansion phase that could create 16,000 jobs
The first building will have 11 floors and include training labs, while the second building will have eight floors and include a pharmacy and an associate gym.
By Ana Mulero • March 22, 2016 -
GAO: CMS isn't analyzing data services hub for public exchanges
The hub serves HealthCare.gov to determine applicant eligibility for exchange plan subsidies.
By Nina Flanagan • March 22, 2016 -
Salaries for top Maine co-op execs under the looking glass, to be scrutinized by regulators
The Maine co-op was profitable in 2014, but it lost more than $17 million last year.
By Ana Mulero • March 22, 2016 -
Anthem files suit against Express Scripts over pharma pricing issues
The insurer is also seeking the right to terminate its contract with the PBM, even though it hasn't decided whether it will do so.
By Jeff Byers • March 21, 2016 -
Supreme Court primed to review ACA contraception mandate this week
Without Scalia on the court, the justices are split evenly down the middle between conservatives and liberals.
By Jeff Byers • March 21, 2016
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