Payer: Page 190
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Healthcare consumers recouped nearly $470M in 2014 from premium rebates
In 2014, 5.5 million consumers received money after insurance companies failed to meet a minimum spending requirement.
By Ned Pagliarulo • Nov. 23, 2015 -
CMS reiterates intent to make good on risk corridors payments
Can CMS really come through, and do it while insurers need it most?
By Heather Caspi • Nov. 23, 2015 -
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 -
Senate fast-tracks House reconciliation bill to repeal pieces of the ACA
The legislation is poised for action, but may get stuck between GOP criticism it either goes too far or not far enough.
By Heather Caspi • Nov. 23, 2015 -
Annual cost of specialty drugs surpasses median household income
An AARP Policy Institute report aims to highlight the financial impact of soaring drug costs even though the insured don't pay retail prices.
By Heather Caspi • Nov. 23, 2015 -
Deep Dive
Life after ICD-10: ICD-11 is coming
Designed to be more EHR-friendly, the World Health Organization is working towards its ICD-11 approval goal of 2017.
By Randy Lilleston • Nov. 21, 2015 -
CMS' 2017 ACA marketplace proposed rule seeks to streamline direct enrollment
The proposed rule includes changes on a variety of proposals and improvements to the premium stabilization programs.
By Jeff Byers • Nov. 20, 2015 -
HHS, OptumLabs join forces on healthcare research
The partnership will first compare and contrast trends in claims records for healthcare costs purposes.
By Heather Caspi • Nov. 20, 2015 -
Pavlov's pigeons? Birds taught to accurately identify breast cancer in X-ray imagery
Pigeons' diagnostic ability to detect cancerous tissue in images rivaled the success rate of pathologists.
By Ned Pagliarulo • Nov. 20, 2015 -
Future unclear for UnitedHealth in ACA marketplace
The insurance giant hints that it might leave the exchanges unless conditions improve.
By Jeff Byers • Nov. 19, 2015 -
VA reveals healthcare network overhaul plan, says it needs $421M
The ambitious proposal would combine seven programs into a single system.
By Nina Flanagan • Nov. 19, 2015 -
Study: Better high blood pressure control linked to Medicaid beneficiaries
They are more knowledgeable about their health than people without insurance living below the poverty line, according to the study.
By Nina Flanagan • Nov. 19, 2015 -
HHS feels the heat from medical groups over 27 states denying bariatric surgery
The action is non-compliant with the ACA, advocates say.
By Nina Flanagan • Nov. 19, 2015 -
ACA plan-shopping saves money, report says
The Kaiser Family Foundation found individuals who switch plans offered via HealthCare.gov may save hundreds of dollars a year.
By Jeff Byers • Nov. 18, 2015 -
Why Maryland's rate-setting experiment should get attention
Could other states get the buy-in to follow Maryland's lead?
By Heather Caspi • Nov. 18, 2015 -
NY puts hold on processing of defunct Health Republic claims
Hospitals and providers stand to lose millions if their claims remain unpaid.
By Heather Caspi • Nov. 18, 2015 -
Deep Dive
Montana Blue Cross/Blue Shield becomes first insurer to oversee Medicaid expansion
The company remains confident the expansion will be ready by a Jan. 1, 2016 deadline.
By Heather Caspi • Nov. 18, 2015 -
Texas hospital cut from Medicare and Medicaid programs
The provider is facing funding fallout from its September patient shooting.
By Heather Caspi • Nov. 18, 2015 -
SEC questions Congress' turf in health policy/insider trading case
A New York judge has enabled a deeper look into a suspected leak of government healthcare policy.
By Heather Caspi • Nov. 18, 2015 -
Bruce Bennett via Getty Images
CVS Health refill programs boost medication adherence, cut waste
Can refill programs solve the $300 billion medication adherence problem?
By Ned Pagliarulo • Nov. 17, 2015 -
CMS outlines star rating system for Medicare-Medicaid plans
Is a separate rating system necessary for dual eligible demonstrations?
By Heather Caspi • Nov. 17, 2015 -
Hips don't lie: A look inside CMS' joint replacement bundled payment rule
This model is being tested in 67 geographic areas throughout the country and set to begin April, 1, 2016, which everyone hopes is not the version of a government practical joke.
By Jeff Byers • Nov. 17, 2015 -
Ohio hospitals slap HHS with lawsuit over two-midnight rule
An estimated $564,106 is on the annual line for six hospitals.
By Jeff Byers • Nov. 17, 2015 -
Mass. insurers aim to curb opioid abuse, costs of addiction
With addictions driving up health costs, some state insurers have little choice than to get involved.
By Heather Caspi • Nov. 16, 2015 -
HealthCare.gov enrollment 'solid' during first week
New customers represented about one-third of enrollees this year's opening week.
By Heather Caspi • Nov. 16, 2015 -
Alabama thinking on Medicaid expansion
The state may be willing to do it, under certain conditions.
By Heather Caspi • Nov. 16, 2015
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