Payer: Page
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CMS online tool reveals Medicare drug spending disparities
The agency, while noting prescription drug spending increased by 12% in 2014, has launched a digital dashboard for the public to view drug spending and usage trends.
By Heather Caspi • Dec. 23, 2015 -
CMS pushes back against risk score 'zombification'
The ACA's risk adjustment program, which shifts money between insurers, hinges on risk score credibility.
By Heather Caspi • Dec. 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 -
Deep Dive
How regulations changed reimbursement in 2015, outlooks for 2016
Three industry experts weigh in on the changing reimbursement regulations, including their effects on Medicare Advantage and payer costs.
By Heather Caspi • Dec. 22, 2015 -
Three big insurers gain most Medicare Advantage members
If the Aetna acquisition of Humana goes forward, the combined organization would be the largest Medicare Advantage company in the U.S.
By Nina Flanagan • Dec. 22, 2015 -
Colorado to vote on single-payer healthcare in 2016
Whether or not residents like the plan, they may not like its pricetag.
By Heather Caspi • Dec. 22, 2015 -
Private health exchanges puts employees in driver's seat to choose benefits
The rising model is, with expanded offerings like wellness and life benefits, are increasingly attractive for many competitive small and mid-sized companies.
By Heather Caspi • Dec. 22, 2015 -
As Medicaid expands, so does room for error
Program expansion is leading to improved outlooks for some insurers, but nearly doubling the rate of improper payments.
By Heather Caspi • Dec. 21, 2015 -
CMS releases fee-for-service data on home health agencies
The data, which identifies individual agencies, are provided for transparency.
By Heather Caspi • Dec. 21, 2015 -
Deep Dive
Is population health business poised to break out in 2016?
Providers, payers, and vendors are warming up to population health but challenges remain.
By Nina Flanagan • Dec. 21, 2015 -
Oscar credits ACA, simple message for enrollment spike
The insurer, known for its quirky ads and user-friendly mobile app, continues to work towards profitability and expansion.
By Heather Caspi • Dec. 21, 2015 -
Kaiser Permanente to teach a thing or two with new medical school
About 44 students will enter the inaugural class in fall 2019.
By Heather Caspi • Dec. 18, 2015 -
VA insurance coverage sends ReWalk stock through roof
The company's shares rose 76% following news veterans will now be eligible for robotic legs coverage.
By Heather Caspi • Dec. 18, 2015 -
Catholic Health, BlueCross BlueShield settle differences, renew agreement
After a lawsuit filed by BlueCross BlueShield of Western New York against Catholic Health was dropped, the organizations are primed to dive into a new three-year agreement.
By Nina Flanagan • Dec. 17, 2015 -
Arkansas task force focuses to finalize state's Medicaid recommendations
As talks continue, the Health Reform Legislative Task Force yesterday approved Governor Asa Hutchinson's efforts to seek federal waivers to explore Medicaid expansion in the state.
By Nina Flanagan • Dec. 17, 2015 -
Medi-Cal sued in Latino civil rights argument
With Latinos comprising the bulk of program recipients, they argue the system is separate and unequal.
By Heather Caspi • Dec. 16, 2015 -
Deep Dive
Payers weigh in on Cadillac tax, digitization and more for 2016
Industry stakeholders share their varied viewpoints, with many agreeing on similar themes.
By Heather Caspi • Dec. 16, 2015 -
UPDATED: President signs omnibus including 'Cadillac' and medical device tax delays
With the president's signature, the ACA's Cadillac tax will be kicked back to 2020 while the medical device tax will be suspended through 2017.
By Jeff Byers • Dec. 16, 2015 -
Major insurer data analysis offers insights into hospital spending
The unprecedented analysis of private U.S. healthcare spending finds, yes, hospital monopolies may affect market prices.
By Heather Caspi • Dec. 16, 2015 -
As risk kicks in, CMS' bundled payment program participation sharply drops
The BPCI program has lost many of its volunteers with the addition of downside risk, causing some experts to question if this drop in participation will influence the agency's decision to continue offering voluntary demonstrations or transition to mandatory programs.
By Heather Caspi • Dec. 16, 2015 -
HHS lends states guiding hand on Obamacare waivers
New agency guidance clarifies states' flexibility to pursue innovative waiver proposals while preserving protections of the ACA.
By Nina Flanagan • Dec. 15, 2015 -
Kaiser Permanente Colorado expansion is not without challenges
The insurer remains optimistic on expanding into two single-hospital counties, but the hospitals have not accepted the insurer for non-emergency visits.
By Nina Flanagan • Dec. 15, 2015 -
States may hold final sway in proposed megamergers
State insurance commissioners have factors to consider beyond antitrust laws.
By Heather Caspi • Dec. 15, 2015 -
Planned Parenthood sues Ohio in preemptive strike
The state and the organization are odds over the disposal of fetal remains.
By Heather Caspi • Dec. 15, 2015 -
HCA ordered to pay $434M over neglected improvement pledges
The company was accused of failing to fulfill agreements from a 2003 acquisition deal.
By Heather Caspi • Dec. 14, 2015 -
The one profitable ACA co-op now losing big
Despite its 2014 success, Community Health Options of Maine is now in the same boat as other co-ops.
By Heather Caspi • Dec. 14, 2015
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