Payer: Page 203
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Meet the consulting firm that advises clients not to pay big hospital bills
...and provides legal counsel to back them up.
By Nina Flanagan • May 14, 2015 -
Knee surgery most popular 'preference-sensitive' treatment among newly-insured, study says
The study may also provide data that regulators need to push back on insurers proposing big rate hikes for 2016.
By Nina Flanagan • May 14, 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 -
Investors believe Aetna merger with Cigna or Humana may be 'imminent'
The incentive behind the possible consolidation could stem from a boom in Medicare business.
By Katie Bo Williams • May 13, 2015 -
Hawaii health exchange headed toward shutdown
Officials at the Hawaii Health Connector are trying to save the system in the face of severe budget issues.
By Heather Caspi • May 13, 2015 -
Deep Dive
Will Blue Shield of California eventually convert to for-profit?
Advocates believe that with enough pressure, the company will have to consider the question—and moreover, that nonprofit plans in other states may see similar scrutiny.
By Heather Caspi • May 13, 2015 -
Uninsured lack confidence, want more info on plans, survey says
Nearly 90% of marketplace enrollees wanted more information on how to use their plans.
By Heather Caspi • May 13, 2015 -
Anthem takes minimal hit to image over data breach
Some consumers view the brand more favorably thanks to its handling of the breach that impacted almost 80 million.
By Heather Caspi • May 13, 2015 -
Hospital reduces c-section rates to avoid being cut from network
The improvements were driven by a new level of data-sharing that sparked some heated physician objections.
By Katie Bo Williams , Julie Henry • May 13, 2015 -
Feds address birth control, transgender care following noncompliance reports
Insurers must comply with the newly-clarified regs within 60 days.
By Heather Caspi • May 13, 2015 -
White House targets two top ACA complaints
Some new regulations will target insurers, but AHIP is placing at least part of the blame on providers.
By Heather Caspi • May 12, 2015 -
Medicare reimbursement for telemedicine close to $14M in 2014
CMS has paid out more than $57 million for telemedicine since 2001—much less than the Congressional Budget Office's estimate at the time.
By Nina Flanagan • May 12, 2015 -
Molina Healthcare revenues jump 53%
The company cites enrollment growth, greater administrative cost efficiency and steady medical care costs.
By Julie Henry • May 11, 2015 -
Blue Shield of California to face state hearing over $1.25B Care1st acquisition
Consumer advocates maintain the insurer is not serving as a nonprofit.
By Julie Henry • May 11, 2015 -
Highmark agrees to pay all unpaid UPMC claims since January
The state is taking a strong stance to protect healthcare consumers caught in the mix.
By Heather Caspi • May 8, 2015 -
UnitedHealthcare to pay $11.5M over alleged payment denials in NC
Similar lawsuits have been filed against the company by medical societies in Connecticut, New York and Tennessee.
By Nina Flanagan • May 7, 2015 -
Former CEO to pay $8M for former billing fraud scheme
The head of a Nevada endoscopy center allegedly told staff to falsify anesthesia records when preparing insurance claims for reimbursement.
By Nina Flanagan • May 7, 2015 -
Deep Dive
Two reports show women's health coverage disconnect, but will it impact payers?
The root of the issue may be insufficient communication over "appropriate" medical management. Or it could be a matter of insufficient enforcement.
By Heather Caspi • May 6, 2015 -
Kaiser goes against grain, proposes to cut rates in Oregon
If the cut is approved, there will be only one plan cheaper for individuals.
By Heather Caspi • May 6, 2015 -
UnitedHealthcare to extend telehealth coverage to 20M
The insurer has arrangements with three telehealth provider networks.
By Heather Caspi • May 6, 2015 -
Allegheny awaits approval on $175M from Highmark for renovations
The provider anticipates an influx of patients from UPMC. But will patients change health systems or change insurers?
By Heather Caspi • May 6, 2015 -
DaVita settles whistleblower case for $495M
This is DaVita's third whistleblower suit since 2012.
By Julie Henry • May 6, 2015 -
Head of Minnesota exchange to step down
Leitz's interim replacement becomes the third chief executive in less than two years at MNsure.
By Heather Caspi • May 5, 2015 -
USDA
California bill would expand coverage to illegal immigrants
The bill might be controversial, but it's not far-fetched.
By Heather Caspi • May 5, 2015 -
Almost half of state exchanges struggling financially
High IT costs and low enrollment numbers are causing financial stress. Will states turn over operations to the feds?
By Julie Henry • May 5, 2015 -
Is Obamacare's controversial 'Cadillac tax' headed for the scrap yard?
The excise tax on high-cost health insurance plans is scheduled to go into effect in 2018 under the ACA.
By Tom Starner • May 4, 2015
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