UnitedHealth leaving Georgia, Arkansas ACA markets

The largest insurer in America hasn't stated whether or not it will leave additional state markets.

By Jeff Byers • April 8, 2016

CMS releases final 2017 summary of benefits and coverage template

The new SBC includes a coverage example for a simple fracture and information on cost-sharing and hyperlinking capabilities. 

By Meg Bryant • April 8, 2016

Explore the Trendline➔

Payer/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

Tenet leaves S&P's 500 index, joins MidCap 400

Beauty store chain Ulta Salon, Cosmetics & Fragrance will take the corporation's place.

By Ana Mulero • April 8, 2016

Former UnitedHealthcare CEO raises $80M for payer startup

Bright Health is betting digital health is on their side as they wade into the murky waters of establishing an insurance business.

By Nina Flanagan • April 7, 2016

Aetna pays employees up to $500 per year to sleep

The insurer argues the investment pays back in worker productivity and improved decision-making.

By Heather Caspi • April 7, 2016

Study identifies top 3 price-shopped procedures

The biggest issue remains getting people to price shop in the first place, researchers say.

By Heather Caspi • April 6, 2016

Report calls on IRS to tap data to find uninsured

Federal officials have the capacity to find many of the uninsured--if they want to, researchers say.

By Heather Caspi • April 6, 2016

Employer-based coverage surprisingly stable post-ACA

Large employers are likely to continue to provide coverage for the next 10 years, the CBO estimates.

By Heather Caspi • April 6, 2016

What happens if Obamacare is repealed?

It's possible the ACA could be repealed or amended. 

By Julie Henry • April 6, 2016

Aetna taps Hertz lawyer as new general counsel and EVP

The insurer's newest top execs know a thing or two about building brand loyalty.

By Heather Caspi • April 5, 2016

FL officials OK Anthem/Cigna acquisition, downplay state antitrust concerns

Florida's Office of Insurance Regulation said neither company has a dominant presence in the state's market.

By Nina Flanagan • April 5, 2016

ACA, ICD-10 driving healthcare payer BPO market to hit $34.2B by 2022, report finds

Other key market influencers include an aging population and more insurance coverage. 

By Nina Flanagan • April 5, 2016

Hospice provider AseraCare prevails over DOJ in twisty fraud case

Case observers say the decision was reached through a highly unusual and debatable process.

By Heather Caspi • April 4, 2016

Government primes federal cybersecurity reporting rules for insurers

Insurers covering federal employees will have to satisfy new reporting requirements.

By Heather Caspi • April 4, 2016

CMS' final 2017 Medicare Advantage rates lower than expected

The updates are designed to improve payment accuracy for plans that serve dually eligible or low-income beneficiaries. 

By Ana Mulero • April 4, 2016

Humana CEO's op-ed outlines optimism for Medicare Advantage

While waiting for its acquisition from Aetna to close, CEO Bruce Broussard is touting the benefits of its 3.3 million Medicare Advantage members.

By Meg Bryant • April 1, 2016

Drug data in ACA risk pools: A wonky topic insurers, pharma & gov can agree on

Following the release of CMS white paper, insurers and pharma show support for using drug data to compare whether various patients pools' risk assessment.

By Meg Bryant • April 1, 2016

BCBSA study finds ACA patients cost 20% more

The report finds ACA enrollees to have been higher utilizers of medical services.

By Heather Caspi • March 31, 2016

How a $70M healthcare fraud can get you five years in prison

Damien Mayol received a five-year prison sentence for participating in a scheme used to develop an illegal kickback operation.

By Nina Flanagan • March 31, 2016

CAQH Index: E-admin transactions can save healthcare industry $8 billion annually

On the provider side, automated eligibility and benefits processes could save more than $5 billion every year, the nonprofit found.

By Nina Flanagan • March 31, 2016

HCA hospitals, Molina battle brewing over $88M in reimbursements

The issue, surrounding out-of-network emergency care expenses, highlights a trend in narrow network health plans.

By Heather Caspi • March 30, 2016

Anthem/Cigna merger takes heat during hearing by California insurance commissioner

Dave Jones, the commissioner of California's Department of Insurance, has to approve or reject the pending deal. 

By Nina Flanagan • March 30, 2016

Healthcare payer mergers: Pros & cons

Consolidation in the insurance industry could allow insurers to bargain with providers on more equal terms.

By Julie Henry • March 30, 2016

NYC Health + Hospitals hinges financial future on EMR, growth

On the brink of a controversial new EMR launch, the city health system is working to dig its way out of a financial hole.

By Heather Caspi • March 30, 2016

Humana study promotes wellness program benefits, increased productivity

Participants saw their health costs go down and productivity go up, the insurer says.

By Heather Caspi • March 30, 2016