Payer: Page 186
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Sanders' new healthcare plan leaves much to the imagination
Some say the "single-payer" plan, lacking certain details, is still no plan at all.
By Heather Caspi • Jan. 19, 2016 -
Elizabeth Regan/Healthcare Dive
Deep DiveMeet MACRA, health IT's next great hope
As meaningful use is set to be phased, MACRA switches focus to value-based payments.
By Nina Flanagan • Jan. 19, 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 -
Is risk adjustment having a 'reverse Robin Hood' effect?
With one former HHS official calling risk adjustment a "dark art," small insurers are paying up to industry giants under the controversial ACA provision.
By Heather Caspi • Jan. 15, 2016 -
MetLife weighs sale of domestic retail units
Driving factors to separate parts of its U.S. retail business are costs and a tighter regulatory environment, MetLife Chairman and CEO Steven Kandarian said.
By Meg Bryant • Jan. 15, 2016 -
Obama tries to lure Medicaid expansion holdouts
The proposal seeks to offer newcomers as good a deal on Medicaid expansion as the earliest adopters.
By Heather Caspi • Jan. 15, 2016 -
Deep Dive
10 negotiating tactics to stay in the M&A game
Hogan Lovell's attorney Torrey McClary shares some negotiations tips to avoid disruptions and ensure all members of the negotiating team agree to the same terms and goals.
By Meg Bryant • Jan. 15, 2016 -
Montgomery County Planning Commission
Aetna's Bertolini vows to stay the course on ACA exchanges
Aetna’s public health exchanges account for 5% of total membership and 6% of operating revenues — hardly enough to “break the bank,” CEO Mark Bertolini said.
By Meg Bryant • Jan. 14, 2016 -
WEDI CEO Devin Jopp resigns
As head of WEDI, Jopp played a leading role in advancing ICD-10.
By Meg Bryant • Jan. 14, 2016 -
ACA enrollees driving growth, higher than expected, insurers say
Anthem said 2015 enrollment is expected to be above their predictions. The high number of insurance enrollees, according to HCA's CEO, is expected to drive more growth for hospitals.
By Nina Flanagan • Jan. 14, 2016 -
Kindred Healthcare doles out $125M to settle Medicare scheme allegations
The organization allegedly provided unneeded therapy services to nursing home patients.
By Nina Flanagan • Jan. 14, 2016 -
KPMG: Healthcare M&A activity projected to be among top sectors through 2016
A survey showed healthcare is projected to be the third most active sector for M&A through 2016, following the technology and biopharma sectors.
By Nina Flanagan • Jan. 14, 2016 -
State attorneys general work with DOJ to review pending mega-mergers
Additional scrutiny may make it harder for the industry's two largest mergers to get approval.
By Heather Caspi • Jan. 13, 2016 -
Deep Dive
Will AHIP survive major payer departures?
With the changing landscape of health insurance comes change in industry representation.
By Heather Caspi • Jan. 13, 2016 -
Late enrollments destabilizing market, insurers say
The Obama administration is addressing concerns special enrollment periods may be subject to abuse.
By Heather Caspi • Jan. 13, 2016 -
Kentucky governor makes good on vow to shutter state insurance exchange
Bevin has already halted marketing for Kynect.
By Meg Bryant • Jan. 13, 2016 -
Late sign-ups for ACA plans get tighter limits
Highly promoted late-enrollment opportunities are now being scaled back.
By Heather Caspi • Jan. 13, 2016 -
Louisiana Gov. Edwards signs order to expand Medicaid
The governor, sworn in this Monday, wasted no time signing an executive order that will make 300,000 state residents eligible for the program.
By Jeff Byers • Jan. 13, 2016 -
Biggest U.S. nonprofit health system embraces transparent pricing
The move by Ascension’s St. John Health System reveals true cost more than ever.
By Heather Caspi • Jan. 13, 2016 -
Report: Disadvantaged population can impact hospital's performance
The findings are likely to intensify debate among those who argue social factors in risk adjustment enables lower-quality care for riskier patients and reduces incentives to improve.
By Meg Bryant • Jan. 13, 2016 -
U.S. task force finalizes breast screening recs, muddies guideline waters
The recommendations put the government at odds with American Cancer Society guidelines issued last October.
By Meg Bryant • Jan. 13, 2016 -
21 participants join new Next Generation ACO program
Allowing up to 100% financial risk, the new model includes a prospectively set benchmark and offers beneficiaries the choice to be aligned to the ACO.
By Heather Caspi • Jan. 12, 2016 -
Hospitals continue to file lawsuits against HHS' two-midnight rule
Last Friday, more than 50 hospitals filed a lawsuit against HHS Secretary Sylvia Burwell over the controversial measure.
By Nina Flanagan • Jan. 12, 2016 -
Humana says membership, revenue to drop this year
The insurer expects 300,000 members will drop their insurance coverage by the end of the year.
By Nina Flanagan • Jan. 12, 2016 -
Idaho governor announces alternative plan to Medicaid expansion
State legislators support addressing the coverage gap, but not via the ACA.
By Heather Caspi • Jan. 11, 2016 -
UnitedHealth warns N.Y. of low rates following state's co-op failure
The insurer is taking issue with state regulators for factoring risk-adjustment payments into rate limits.
By Heather Caspi • Jan. 11, 2016
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