Payer: Page 187
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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 -
CMS, private payers play nice, agree to 7 sets of clinical quality standards
While the new sets showcase cooperation between payers and the federal government, two national organizations have a bone to pick with two measures.
By Jeff Byers & Ana Mulero • Feb. 16, 2016 -
Zenefits probe continues: Company faces further investigation in California
Zenefits is facing more revelations related to compliance in training their workforce.
By Tom Starner • Feb. 16, 2016 -
CMS to pay $7.7B for ACA reinsurance payouts
The money will certainly be needed for ACA plan carriers that took on a large number of high-cost members.
By Ana Mulero • Feb. 16, 2016 -
Study: Top ranked hospitals decreasing participation in marketplace plans
Most participate in at least one marketplace plan--but the question is for how long.
By Heather Caspi • Feb. 15, 2016 -
CBO analyzes ACA impact on private insurance premiums
The report looks at why premiums for private health insurance are "high and rising."
By Heather Caspi • Feb. 15, 2016 -
Deep Dive
Few signs employer-based health insurance is buckling under ACA
By most accounts, the workplace benefit market appears to be strong, if not thriving.
By Meg Bryant • Feb. 15, 2016 -
Cigna C-suite exec stands apart with optimistic tone for ACA exchanges
Although it continues to lose money in the marketplaces, Cigna stays positive.
By Heather Caspi • Feb. 15, 2016 -
Regulatory barriers limit access to opioid addiction medication
Federal officials are looking to address two issues that stand in the way of addiction treatment.
By Heather Caspi • Feb. 15, 2016
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