Payer: Page 187
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Deep Dive
The profitable Maryland ACA co-op lays out 3 strategies for profitability in 2016
Evergreen is proving a beacon of success among the small ACA start-ups.
By Heather Caspi • March 15, 2016 -
UnitedHealth's Harken Health to expand its unique healthcare model to other cities
Slowly and surely, Harken Health is expanding operations while UnitedHealthcare is throwing shade to the ACA exchanges.
By Nina Flanagan • March 15, 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 -
Physician groups, AMA press Florida to refuse Aetna/Humana deal
The outcry comes after the state has already made some momentum toward acceptance.
By Heather Caspi • March 15, 2016 -
Deep Dive
Convenient care, but at what price? The rise in retail health clinics
More than 50% of the U.S. population lives within 10 miles of a CVS Health MinuteClinic. And healthcare consumers, athenahealth CEO Jonathan Bush notes, expect fast, accessible care and are “voting with their feet.”
By Meg Bryant • March 14, 2016 -
Alex Wong via Getty Images
Health privacy compliance experts predict OCR to conduct around 220 audits this year
HHS' Office of Inspector General criticized the organization's Office for Civil Rights for being lax in its health privacy compliance enforcement program.
By Nina Flanagan • March 14, 2016 -
ACA enrollment challenges persist, 2015 target missed
The Obama administration missed their 2015 enrollment goal by about 3%.
By Ana Mulero • March 14, 2016 -
Humana faces $3.1M penalty over Medicare violations
In addition, Humana CEO Bruce Broussard stands to receive a $40.2 million “golden parachute” paycheck if the Aetna merger closes.
By Meg Bryant • March 11, 2016 -
CMS' Slavitt calls Iowa, Nebraska co-op criticism 'fair'
The ACA co-ops' failure has resulted in a $1.2 billion debt in federal loans, the bulk of which will unlikely be recouped.
By Ana Mulero • March 11, 2016 -
HealthCare.gov CEO assuages marketplace fears, stresses stability
HealthCare.gov CEO Kevin Counihan recently addressed a health exchange forum and promoted the maturity of the marketplace.
By Nina Flanagan • March 10, 2016 -
Insurers lobby FCC for guidance on consumer contact
The Telephone Consumer Protection Act (TCPA) was clarified last summer by the FCC to include text messages but provided an exception for "healthcare providers" without defining the term.
By Nina Flanagan • March 10, 2016 -
Utah compromises with small Medicaid expansion
Democrats have complained it's nothing compared to a full Medicaid expansion.
By Heather Caspi • March 10, 2016 -
Amateria1121 [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons
Oregon considers software vendors for health insurance marketplace
The state is reviewing proposals from four companies to develop a new software platform for its health insurance marketplace.
By Nina Flanagan • March 10, 2016 -
This New Jersey lawyer is using statistics to target possible Medicare fraudsters
While the government can and does bring cases against alleged fraudsters, a more successful route has been qui tam lawsuits,
By Meg Bryant • March 9, 2016 -
CMS challenged over changes to Medicare Advantage retiree plan rates
On average the proposed payments to insurers would increase in 2017--but not for retiree plans.
By Heather Caspi • March 9, 2016 -
AHIP Policy 2016: HCCI chair calls for national healthcare data warehouse to improve transparency, decrease costs
The growth of healthcare spending is slowing down but it is still increasing.
By Ana Mulero • March 9, 2016 -
A peek into the recently unsealed whistleblower lawsuit against Humana
A physician has accused the insurer of promoting upcoding to maximize Medicare Advantage payments. The question now begs whether the case has any bearing on Aetna's pending aquisition of the insurer.
By Heather Caspi • March 9, 2016 -
Aetna/Humana is cause for concern for Medicare Advantage market, analysis says
If previous mergers are any indication, divestitures are not a solution.
By Heather Caspi • March 9, 2016 -
Deep Dive
Health insurance market entrants face cold, lonely path ahead
Those intrepid enough to step into the "extremely difficult" business climate will have to overcome the already-established relationships between enrollees and other plans.
By Heather Caspi • March 8, 2016 -
The rise of long-term care plans in life insurance plans
Hybrid policies provide long-term care with life insurance or a fixed annuity.
By Nina Flanagan • March 8, 2016 -
Deep Dive
'Doctorpreneurs' breathing new life into healthcare seed funding
Instead of building something that works great outside of healthcare, and trying to force-fit it into healthcare, innovators must take the opposite approach—working first with investors or partners
By Meg Bryant • March 8, 2016 -
Is a Maryland health exchange getting a 'free pass' on its budget?
Watchdogs suggest state legislators should be asking questions--many of them.
By Heather Caspi • March 8, 2016 -
Fine furthers Tenet rough patch
While the company sorts through setbacks and losses, its stock price is looking up.
By Heather Caspi • March 8, 2016 -
New Hampshire upgrades healthcare cost comparison website
The state, already considered to have the best such tool, continues forging ahead.
By Heather Caspi • March 7, 2016 -
Savvy healthcare consumers may not truly impact health care spending
A recent research report digs into consumer-driven healthcare – and finds it may not save as much money as employers believe.
By Tom Starner • March 7, 2016 -
Maryland co-op taps into special sauce, announces record revenue
Evergreen Health is bucking the co-op trend with its strong 2015 results.
By Heather Caspi • March 7, 2016
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