Payer: Page
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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 -
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 -
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 -
NC ACA marketplace could lose its biggest carrier
As Blue Cross is the only ACA plan that covers all 100 counties in North Carolina, more than 300,000 residents could be affected if the insurer leaves the marketplace.
By Meg Bryant • Feb. 12, 2016 -
CMS eases final rule requiring providers, suppliers to report overpayments
The agency seeks to clarify requirements for the reporting and returning of self‑identified overpayments but will insurers get behind it?
By Jeff Byers • Feb. 11, 2016 -
McKesson, HealthQX partner on bundled payment technology
The move follows on the heels of CMS' final rule for the first mandatory bundled payment program.
By Heather Caspi • Feb. 11, 2016 -
Humana reconsiders ACA exchanges after 30% Q4 profit drop
Not unlike other insurers, Humana is struggling with higher than expected medical costs for new ACA enrollees.
By Heather Caspi • Feb. 11, 2016 -
Bevin's pick for Medicaid chief has background in healthcare, finance
Stephen Miller will be tasked with scaling back the Medicaid expansion that took place under Bevin’s predecessor.
By Meg Bryant • Feb. 10, 2016 -
Obamacare faces quandary of 30 million still uninsured
The ACA will never achieve universal coverage, but it could get closer, experts say.
By Heather Caspi • Feb. 10, 2016 -
CMS explains new special enrollment period
A tax issue is allowing some people to take through March to sign up for ACA plans.
By Heather Caspi • Feb. 10, 2016 -
FDA
Possible compounding cream fraud thought to amount to half a billion
Insurers were billed as much as $10,000 for a single tube.
By Heather Caspi • Feb. 10, 2016
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