Payer: Page
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Deep Dive
Surprise medical bills: Who should cover the costs?
Parties disagree as to whether insurers should cover the extra costs or providers should bill at in-network rates.
By Julie Henry • April 19, 2016 -
GOP legislators blast CMS for prioritizing reinsurance
The argument centers around a CMS rule that's putting reinsurance payments before Treasury payments.
By Heather Caspi • April 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 -
UnitedHealth to remain only in 'handful' of ACA markets next year
The announcement comes as the Obama administration downplayed the potential actions of one health insurer, albeit the nation's largest.
By Jeff Byers • April 19, 2016 -
CMS chops controversial two-midnight rule payment cut
The agency has additionally proposed to offset the fiscal effects of the policy from the last three years.
By Jeff Byers • April 19, 2016 -
How a tech glitch caused 1.9K pregnant women to lose their Covered California coverage
Some women would be best not to report their pregnancy if they want to keep their health plan through the state's marketplace until the flaw is fixed.
By Nina Flanagan • April 19, 2016 -
Health Affairs: Next Gen ACO model not to be overlooked
The national Next Gen ACO model is the most attractive being offered today, bloggers argue.
By Heather Caspi • April 18, 2016 -
Future of Cadillac Tax to get bipartisan discussion
Though delayed, the controversial provision still looms ahead.
By Heather Caspi • April 18, 2016 -
UnitedHealth to drop out of Michigan ACA marketplace in 2017
The decision marks the third individual-coverage market the insurer will exit next year.
By Ana Mulero • April 18, 2016 -
Humana's wellness program to rebrand as 'Go365'
The program will offer members a more personalized approach to their health beginning January 2017.
By Heather Caspi • April 18, 2016 -
Thinking of starting a provider-led health plan? Ask these four questions
In a recent analysis, 40 of 89 provider-led health plans had negative margins during the past three years.
By Meg Bryant • April 15, 2016 -
Elizabeth Regan/Healthcare Dive
ACOs show modest savings in first full year
Organizations in the Medicare Shared Savings Program were able to maintain or improve certain care performance measures.
By Meg Bryant • April 15, 2016 -
Individual market to look up after 2017, analysts predict
In 2014, insurers lost about $3 billion in the marketspace but it could become more viable as insurers gain experience pricing their products.
By Heather Caspi • April 14, 2016 -
HHS report debunks fear of a double-digit Obamacare premium increase
As 67% of HealthCare.gov consumers opted for a new plan in 2016, HHS states premiums depend on market dynamics as a whole, not just payer pricing decisions.
By Meg Bryant • April 13, 2016 -
Insurers' experience all over the map during first ACA risk adjustment year
An analysis by the American Academy of Actuaries states premiums need to reflect the level of risk in an entire market pool, not just insurers' beneficiaries.
By Meg Bryant • April 13, 2016 -
Deep Dive
Insurers take on obesity prevention
Many insurers are going above and beyond with both local and national obesity prevention efforts.
By Julie Henry • April 13, 2016 -
Humana flub tells 12K people their drugs not FDA approved
The incident impacted a portion of Humana's Texas enrollees.
By Heather Caspi • April 13, 2016 -
Health insurers pay for obesity -- one way or another, experts say
The cost of denying obesity care could exceed that of providing it, experts say.
By Heather Caspi • April 13, 2016 -
Short-term health policy sales surge despite plan limitations
Those who develop health problems can always switch to a ACA plan to cover pre-existing conditions, insiders note.
By Nina Flanagan • April 12, 2016 -
Deep Dive
How the disruptive insurer Harken Health is tackling the Illinois, Georgia markets
The insurer is optimistic after opening its primary care sites in Chicago and Atlanta.
By Nina Flanagan • April 12, 2016 -
Florida, California take on surprise medical bills
Two more states are pursuing legislation akin to that established in New York.
By Heather Caspi • April 12, 2016 -
New York expects to enroll 470,000 in low-cost health plan
The state is targeting its remaining uninsured with this new option available under the Affordable Care Act.
By Heather Caspi • April 12, 2016 -
Covered California first state exchange to set quality, cost standards for health plans
The organization will exclude providers offering low-quality or over-priced care from plan networks as soon as 2019.
By Heather Caspi • April 11, 2016 -
Majority of Americans say healthcare price, quality not connected
Perceptions of a price/quality connection could impact the movements toward transparency and price shopping.
By Heather Caspi • April 11, 2016 -
GAO report highlights ACA state exchange security flaws
Hundreds of thousands of users' data were vulnerable to hackers in California, Kentucky and Vermont's exchange websites.
By Heather Caspi • April 11, 2016 -
New CMS payment model largest multi-payer initiative to date, could include 20K doctors
The Comprehensive Primary Care Plus model seeks to give providers freedom to deliver care that best meets patients' needs.
By Jeff Byers • April 11, 2016
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