Sacred Heart and Florida Blue sign new contract

The two ended a contract dispute just ahead of their July 1 deadline.

By Heather Caspi • June 26, 2015

What does 'private exchange' actually mean?

A new report sheds light on why adoption estimates are so varied.

By Heather Caspi • June 24, 2015

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

New York poised to pass health coverage law for pregnancy

The state is expected to become the first to make pregnancy a qualifying life event. Will California follow suit?

By Heather Caspi • June 24, 2015

Massachusetts gets mixed results in effort to reduce readmissions

Readmissions among individuals covered by public payers comprise 81% of all readmissions in the state.

By Heather Caspi • June 24, 2015

UnitedHealth to leave AHIP

This is a huge statement that raises more questions than it answers. Right now, UnitedHealth's decision to leave is a mystery.

By Heather Caspi • June 24, 2015

Salem Health, United Healthcare resolve contract dispute

A disruption to in-network coverage would have impacted an estimated 10,000 United Healthcare customers.

By Heather Caspi • June 23, 2015

Aetna makes bid for Humana; companies quiet

Don't get too excited just yet, experts say.

By Heather Caspi • June 23, 2015

What Trinity, Ascension are doing to prepare for King fallout

The possible loss of billions in subsidies is forcing providers to strategize ahead, creating sometimes-controversial solutions.

By Heather Caspi • June 23, 2015

Bills would require parity for IV and oral chemo coverage

According to AHIP, such legislation would result in a commensurate rise in premiums.

By Heather Caspi • June 22, 2015

PA asks: Are insurance navigators sufficiently regulated?

One expert says: Navigators are entrusted with PHI, so they should be held to the same security standard as other insurance professionals. 

By Heather Caspi • June 22, 2015

Cigna rejects public Anthem offer for $47B

One of the problems: Anthem wants Joe Swedish to act as president, CEO, chairman and "head of integration" for the combined companies.

By Katie Bo Williams • June 22, 2015

CMS announces boost to reinsurance rate—to 100%

Several insurers have already calculated their expected payments from the program and assumed a 100% reinsurance rate.

By Heather Caspi • June 19, 2015

Investors advise caution as speculation around Big Five mergers grows

"I just don't get the feeling that there is [a] thoughtful, disciplined, controlled process, and that concerns me," said one analyst. 

By Katie Bo Williams , Nina Flanagan • June 18, 2015

Are insurers in a 'race to the bottom' to adopt adverse tiering?

When deciding whether to utilize the controversial practice, insurers may be between a rock and a hard place.

By Heather Caspi • June 17, 2015

Meridian growth prompts massive hiring spree

The health plan anticipates tripling its revenue—to $3 billion—by the end of this year. 

By Heather Caspi • June 17, 2015

UPMC Health goes after Highmark customer group

The group's no-bid contract "deprives members of choice in their healthcare," UPMC says. 

By Heather Caspi • June 17, 2015

Anthem surpasses UnitedHealth as largest US health plan, report says

UnitedHealth dropped out of the top slot for the first time in three years—but the results depend on whether Medigap is counted.

By Heather Caspi • June 17, 2015

Cigna rejects $175-per-share offer by Anthem: Wall Street Journal

Cigna is one of the most likely candidates to purchase Humana, experts say. 

By Heather Caspi • June 16, 2015

How providers and payers can bridge the disease management gap to cut costs

How can organizations work together to more effectively manage chronic conditions?

By Julie Henry • June 15, 2015

PA woman defrauds Highmark to the tune of $600K in prescriptions

Company efforts to combat waste, fraud and abuse "had a financial impact of more than $100 million in 2014," Highmark said in a statement.

By Heather Caspi • June 15, 2015

Express Scripts, insurers press for pay-for-performance drug pricing

But is the pharmaceutical industry on board?

By Heather Caspi • June 15, 2015

CMS pays out $1.3B to hospitals to clear Medicare appeals backlog

RACs say the deal "incentivizes hospitals to continue to overwhelm the system with frivolous appeals."

By Katie Bo Williams • June 15, 2015

Elizabeth Holmes to AHIP meeting: DTC testing is key to health reform

Critics still doubt both the accuracy of Theranos tests and the wisdom of direct-to-consumer testing. 

By Nina Flanagan • June 11, 2015

Independence Blue Cross algorithm that predicts admissions faces privacy concerns

"The healthcare data we provided to build these algorithms is equivalent, I think, to five Wikipedias," CIO Somes Nigam told NPR.

By Heather Caspi • June 10, 2015

Assurant Health closes doors on losses 'significantly worse than anticipated'

The insurer announced in April that it would close its doors if it did not find a buyer. 

By Katie Bo Williams • June 10, 2015