Payer: Page 2

Centene Q3 profit skyrockets on WellCare close, ACA settlement

Lower utilization of healthcare services during the quarter was partially offset by higher testing and treatment costs for COVID-19, the payer said. Analysts called the results "good enough."

By Samantha Liss • Oct. 27, 2020

4 healthcare storylines overshadowed by COVID-19

The magnitude of the crisis has all but stopped some efforts, like a ban on surprise billing. But other policies are forging ahead, including price transparency requirements for hospitals beginning Jan 1.

By Shannon Muchmore • Oct. 22, 2020

Explore the Trendline➔

Trendline

Social determinants of health

The focus on social determinants of health has only increased as the COVID-19 pandemic has devastated the United States.

By Healthcare Dive staff

Envision, Cigna avert out-of-network status in Florida

A deal between the private equity-backed staffing group and insurer ensures that thousands of clinicians remain in network during a deadly pandemic, averting potential for surprise medical bills.

By Samantha Liss • Oct. 22, 2020

COVID-19 has sparked more concerns about healthcare costs, insurance, TransUnion says

More people, especially those in younger generations, are using insurer websites to conduct cost research, the annual survey found.

By Ron Shinkman • Oct. 21, 2020

ACA plan premiums to fall 2% in 2021, CMS says

The price easing comes despite the Trump administration's efforts to chip away at the law, including support for the case to overturn it now before the Supreme Court. But affordability remains a challenge for some who don't get subsidies.

By Rebecca Pifer • Oct. 20, 2020

CVS wants pharmacy techs to administer COVID-19 vaccine, plans to hire 10,000 more

This week the Trump administration released guidance authorizing pharmacy technicians and pharmacy interns to administer coronavirus vaccines and COVID-19 diagnostic tests.

By Rebecca Pifer • UPDATED: Oct. 23, 2020 at 9:25 a.m.

MA plans see more minorities, dual eligibles signing up

Medicare Advantage has been a key revenue driver for big payers like UnitedHealth and Cigna, which are expanding their footprints.  

By Shannon Muchmore • Oct. 16, 2020

CMS grants Medicaid waiver to Georgia; exchange opt-out remains on table

The agency has approved a modest Medicaid expansion waiver for Georgia, and is apparently nearing OK of a second waiver that would allow the state to stop using the Healthcare.gov insurance exchange.

By Ron Shinkman • Oct. 15, 2020

CMS expands Medicare emergency telehealth coverage with 11 new services

The agency also said more than 36% of those in traditional Medicare used a virtual visit between March and August and usage among Medicaid members has skyrocketed.

By Rebecca Pifer • Oct. 15, 2020

UnitedHealth says Q3 volume rebounds, net income down on consumer price breaks

Still, the first payer to report quarterly earnings bested Wall Street expectations and saw a lower-than-expected medical cost ratio of 81.9% for the third quarter.

By Samantha Liss • Oct. 14, 2020

Payer competition shrinks in already scarce markets, AMA survey finds

The five insurers with the biggest share in the most markets were Anthem, Health Care Service Corp., UnitedHealth Group, Florida Blue and Highmark.

By Hailey Mensik • UPDATED: Oct. 15, 2020 at 10:02 a.m.

Teladoc-Livongo make first combined sale to Guidewell Health

The Florida Blue plan, which has been a Teladoc client for several years, will now offer Livongo's diabetes platform to some 50,000 members. Executives claimed more interest behind the scenes Monday at HLTH.

By Rebecca Pifer • Oct. 13, 2020

Medicare coronavirus vaccine pay rule predicted by month's end, Verma says: HLTH 2020

It's unclear whether CMS has the regulatory power to reimburse for a vaccine if approved by the FDA under an emergency use authorization, as public health officials expect. The rule will likely tackle that.

By Rebecca Pifer • Oct. 13, 2020

Employer healthcare costs stable in 2020, COVID-19 impact still unclear, KFF says

Still, despite modest premium growth, the annual Kaiser Family Foundation Employer Health Benefits survey notes costs for family coverage rose double the rate of inflation over the past five years.

By Ron Shinkman • Oct. 08, 2020

Medicare Advantage enrollees in 4-star or higher plans to drop in 2021

Cigna appears a winner as about 88% of its members will be in plans with four or more stars. Hitting higher scores gives plans the chance to nab lucrative bonuses. 

By Samantha Liss • Oct. 08, 2020

Most employers won't turn to healthcare cost shifting in 2021, Mercer says

Months into a public health crisis, the outlook for employer-sponsored healthcare could shift significantly due to deferred care.

By Ryan Golden • Oct. 08, 2020

Walmart enters Medicare broker market, threatening incumbents

The massive retailer plans to sell MA, supplement and prescription drug plans from major insurers like UnitedHealthcare and Humana during this year's annual enrollment period.

By Rebecca Pifer • Oct. 07, 2020

More than 14M may have lost health coverage after historic job losses, study finds

Not all lost jobs result in a loss of coverage, so researchers have been keen to figure out how historic unemployment has ultimately affected insurance status.

By Samantha Liss • Oct. 07, 2020

MA startup Clover Health goes public in blank check deal valuing it at $3.7B

The transaction expected to close in early 2021 is the latest in a string of IPOs and deals for digital-focused healthcare companies.

By Rebecca Pifer • Oct. 06, 2020

Medicare advisers toy with MA payment overhaul as major payers expand for 2021

MedPAC commissioners floated a new methodology in the Medicare Advantage program blending local and national spending, but pushback from payers is likely if the change is finalized.

By Rebecca Pifer • Oct. 05, 2020

UnitedHealth, Cigna to expand Medicare Advantage footprints, touting telehealth for 2021

Humana, Anthem and Aetna are also moving into new geographies with the popular and lucrative program. In addition, smaller player Clover Health is partnering with Walmart to offer plans in Georgia.

By Shannon Muchmore • Oct. 02, 2020

Patients give high marks to telehealth, J.D. Power says

The survey of more than 4,300 people ranked Amwell and Doctor on Demand as well as insurers. Sicker patients were less likely to report a positive experience.

By Ron Shinkman • Oct. 01, 2020

Deep Dive

Election 2020: Trump and Biden's starkly diverging views on healthcare

Spoiler: the two nominees diverge on almost everything.

By Rebecca Pifer • Oct. 01, 2020

4M added to Medicaid rolls due to coronavirus pandemic

The job market — which many rely on for commercial insurance coverage — is likely to remain strained as long as the U.S. fails to contain the spread of the novel coronavirus. The resulting shift in payer mix is unfavorable for providers.

By Samantha Liss • Oct. 01, 2020

$6B fraud bust includes numerous telehealth schemes

Providers quickly pivoted many services to virtual care during the COVID-19 pandemic, potentially inviting fraud.

By Shannon Muchmore • Oct. 01, 2020