Payer: Page 2
-
Urgent care centers draw some ER visits but associated with higher spending overall
The findings published in Health Affairs may suggest patients are going to the centers instead of more appropriate and lower cost settings like a primary care office or virtual visit.
By Shannon Muchmore • April 07, 2021 -
Brian Thompson named CEO of UnitedHealthcare
The executive, who joined UnitedHealth Group in 2004, was most recently head of UnitedHealthcare's government business, including its Medicare, retirement and community and state divisions.
By Rebecca Pifer • April 07, 2021 -
Explore the Trendline➔
Getty
TrendlineValue-based care
As medical costs continue to skyrocket, some hope the COVID-19 pandemic will nudge providers to adopt value-based care as they look to diversify revenue streams, bringing the movement back on track.
By Healthcare Dive staff -
Medtechs top pharma in cash to doctors for consulting, travel: Health Affairs
The study also found payments from medical device companies increased greatly as Medicare billing increased among surgeons.
By Ricky Zipp • April 07, 2021 -
Medtronic inks value-based care pact with Spectrum Health
The risk-based deal, initially focused on cardiac resynchronization therapy, will have the medtech giant paying the provider if certain patient metrics are not met, according to a spokesperson for the health system.
By Nick Paul Taylor • April 01, 2021 -
Dollar Photo Club
One-third of small businesses say health insurance is a top concern during COVID-19: survey
The new poll from the Small Business Majority and Families USA also found that pain is particularly acute among Black-, Asian American- and Latino-owned businesses, which tend to have fewer resources than their White counterparts.
By Rebecca Pifer • March 31, 2021 -
Payer lobbies cheer new bipartisan bill allowing audio-only telehealth in MA
"Lawmakers have recognized the importance of telehealth, and this important legislation recognizes that for many seniors, a phone call is their only option for health care at home," AHIP CEO Matt Eyles said Wednesday.
By Rebecca Pifer • March 25, 2021 -
Reality check: Amazon Care may not be that big of a deal
Currently, the effort is a more direct threat to employer-facing point solutions, instead of the more comprehensive offerings from entrenched vendors.
By Rebecca Pifer • March 23, 2021 -
Courtesy of Humana
Humana CFO to depart
Susan Diamond, president of the health insurer's home business, will assume the role of interim CFO on June 1 while Humana completes an external search for Brian Kane's replacement.
By Jane Thier • March 23, 2021 -
E.A. Crunden/Healthcare Dive
House passes bill that would extend Medicare sequester cuts until December
The cuts will go back into effect March 31 and the bill now awaits action from the Senate. The hospital industry has been pushing hard for a delay.
By Hailey Mensik • March 19, 2021 -
Retrieved from C-SPAN on February 24, 2021
Becerra confirmed as HHS secretary
The 50-49 vote in the Senate was almost entirely along party lines. The only Republican to cross the aisle was Sen. Susan Collins of Maine.
By Shannon Muchmore • March 18, 2021 -
Permission granted by Health Affairs
Q&AHealth Affairs' Alan Weil reflects on 1 year of COVID-19
The editor in chief of the respected industry journal spoke with Healthcare Dive about the role of equity in health research, the staying power of telemedicine and how to effectively communicate important public health messages.
By Shannon Muchmore • March 18, 2021 -
MICHAEL PRINCE via Getty Images
CMS puts the brakes on breakthrough device coverage rule
The policy would automatically OK Medicare reimbursement for devices with FDA breakthrough status, but critics contend the rule would undermine CMS authority to consider the clinical evidence backing new technologies.
By Susan Kelly • March 17, 2021 -
Despite pandemic, MedPAC advises few changes to 2022 provider payments
To the extent that the effects of the crisis are temporary and vary significantly depending on provider, they're best addressed through targeted yet temporary funding policies, the congressional advisers said in an annual report.
By Rebecca Pifer • March 16, 2021 -
Courtesy of Walmart
CMS hikes COVID-19 vaccine pay, broadens scope of providers to give jab
The AMA praised the boosted reimbursement, intended to speed up distribution of the three currently available shots.
By Shannon Muchmore • March 16, 2021 -
Alex Wong via Getty Images
The top drugs that could be impacted by an obscure provision in the pandemic relief law
Elimination of the so-called penny rule in Medicaid could force drugmakers to pay larger rebates on a number of top medicines, including some HIV, diabetes and anti-inflammatory drugs.
By Jonathan Gardner • March 15, 2021 -
adeline kon/Healthcare Dive, data from Adeline Kon / Healthcare Dive
COVID-19: 1 year later
For the healthcare industry, much has changed, and some of those alterations may be permanent. Hope is beginning to bloom as three coronavirus vaccines have been authorized for emergency use in the U.S.
-
Ohio sues Centene, alleging PBM practices led to millions in overpayments
The payer called the claims "unfounded" in a statement, and said it planned to aggressively defend the integrity of its pharmacy services in Ohio.
By Rebecca Pifer • March 12, 2021 -
Deep DiveHospitals lift curtain on prices, revealing giant swings in pricing by procedure
The eye-popping variations demonstrate "the total insanity of American healthcare pricing," Niall Brennan, CEO of the Health Care Cost Institute, said.
By Samantha Liss , Nami Sumida • March 11, 2021 -
Alex Wong via Getty Images
CMS pushes back kidney care payment model start date to January 2022
It is the second Trump-era payment model President Joe Biden's health administration has recently tweaked.
By Rebecca Pifer • March 10, 2021 -
Countering payers, drugmakers say net prices declined in 2020
Reports from three large pharmaceutical companies indicate increasing rebate payments and discounts to insurers more than offset the average price increases they took on their medicines.
By Jonathan Gardner • March 08, 2021 -
Adobe Stock
COVID-19 among top US telehealth diagnoses for first time
Mental health conditions continue to be the No. 1 telehealth diagnosis nationwide, according to new data from nonprofit Fair Health.
By Rebecca Pifer • March 08, 2021 -
"Medical disposable masks on wooden background" by Marco Verch Professional Photographer and Speaker is licensed under CC BY 2.0
Becerra tells Californians to dispute COVID-19 fees from providers
Patients charged a "COVID fee" from a recent visit should contact their insurer and request a reimbursement, according to a statement from the state's attorney general, who is the nominee for HHS secretary.
By Hailey Mensik • March 04, 2021 -
Support for telehealth Medicare reimbursement gains steam in Congress
Tuesday's House committee mirrored similar Senate panels, in that a permanent expansion to a greater swath of the population enjoys bipartisan support, but legislators are split on what form it should take.
By Rebecca Pifer • March 03, 2021 -
Fotolia
Hillrom steps back from $375M BardyDx deal on reimbursement setback
The hospital products maker said a Medicare contractor's unexpected drop in payment rates for BardyDx's cardiac monitoring technology meant closing conditions for the transaction had not been satisfied.
By Susan Kelly • March 01, 2021 -
National Institute of Allergy and Infectious Diseases. (2020). "Novel Coronavirus SARS-CoV-2" [Micrograph]. Retrieved from Flickr.
CMS moves to stop COVID-19 testing denials, cost sharing in private plans
Congress required comprehensive health plans to cover COVID-19 tests without cost sharing, prior authorization or medical management last year, only for guidance to create uncertainty about the rules.
By Nick Paul Taylor • March 01, 2021
Previous
