Payer: Page 204
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California, New York bills would make pregnancy a qualifying event
Bills in two states could allow pregnant women to purchase health insurance outside of the open enrollment period. Would this drive up costs—or reduce them?
By Heather Caspi • June 10, 2015 -
Deep Dive
Humana sale: Good for payers, bad for providers?
If a sale is in the works, the Big Four companies may soon be the Big Three. How will consolidation impact the market?
By Heather Caspi • June 10, 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 -
Humana deadlocked in dispute with HCA hospitals
If no deal is reached by July 10, Florida will feel the impact statewide.
By Heather Caspi • June 10, 2015 -
Trinity provider acquires 56-bed GA hospital
The Trinity-owned system will not take on any outstanding debt from the new hospital's recent $62-million construction.
By Heather Caspi • June 9, 2015 -
Humana pulls out of healthcare conference amid speculation of merger
The Goldman Sachs Global HealthCare conference on Wednesday will carry on without the insurer's CFO.
By Julie Henry • June 9, 2015 -
PA announces King contingency plan, but faces time crunch
The state is the first to offer a back-up plan in case residents' ACA subsidies are struck down.
By Heather Caspi • June 5, 2015 -
New Medicare disclosure reveals additional $12.4B in payments
Although docs who treated fewer than 11 patients overall are still omitted, "the totals displayed in the file are extremely close" to CMS' internal records.
By Heather Caspi • June 5, 2015 -
TX hospital files $1M suit against big-five insurers over PPO exclusion
Because the three named insurers are the dominant providers of commerical coverage, ETMC is effectively cut out of its entire privately-insured population.
By Nina Flanagan • June 4, 2015 -
Moody's: Medicaid expansion is not a silver bullet for hospitals
Has the impact of reducing bad debt on hospital bottom lines been overstated?
By Nina Flanagan • June 4, 2015 -
Anthem saves $8M by paying docs to enhance preventive care
Physicians were paid to provide extra attention to patients with chronic conditions.
By Heather Caspi • June 3, 2015 -
Anthem announces free college tuition for employees
Employees can now get reimbursed for degrees earned through College for America.
By Heather Caspi • June 3, 2015 -
The 10 cities where insurers pay the most for medical care—and the least
Hint: The low- and high-cost regions for commercial plans don't correspond with the low- and high-cost regions for Medicare.
By Heather Caspi • June 3, 2015 -
Deep Dive
How Aetna and Massachusetts Blue Cross are leveraging mHealth to lower maternity costs
Maternal and newborn care make up the most expensive category of hospital payouts for most private plans and Medicaid programs. Can the right app move the needle?
By Heather Caspi • June 3, 2015 -
Highmark closes merger with Blue Cross of Northeastern Pennsylvania
The deal adds over half a million covered individuals across 13 counties to Highmark's existent 4.7 million customers.
By Heather Caspi • June 3, 2015 -
Will CA become the first state to offer health coverage to illegal immigrants?
The California Senate has cleared a bill that would provide state-subsidized healthcare to illegal immigrants. It heads to the Assembly next.
By Julie Henry • June 3, 2015 -
More big insurers seek double-digit rate increases in 2016
Payers with major market share are asking for 15% to 35% increases.
By Katie Bo Williams • June 2, 2015 -
GAO report faults use of doctors to set Medicare rates
Are physician groups biased in their recommendations?
By Heather Caspi • June 2, 2015 -
Deep Dive
Two charts that explain the Medicare data release of hospital charges
CMS dropped three more huge data sets Monday that could increase scrutiny of hospital sticker prices.
By Katie Bo Williams • June 2, 2015 -
Deep Dive
Mixed reactions to new managed care 'uber rule': What changes are needed?
At least one provider group says the controversial MLR requirement may be too limiting for patients that require auxiliary services like transportation.
By Nina Flanagan • June 1, 2015 -
Single payer in New York? Not likely
The state Assembly overwhelmingly passed a bill that would eliminate insurance companies in the state of New York.
By Heather Caspi • May 29, 2015 -
Study: Overhead costs skyrocket under the ACA
Nearly one out of every four dollars goes straight to administrative costs for health plans.
By Heather Caspi • May 29, 2015 -
Aetna's $4.5M fine included penalty for covering abortions
It's unusual to see an insurer penalized for providing payment.
By Heather Caspi • May 29, 2015 -
BCBS accused of acting as illegal cartel in two consolidated antitrust lawsuits
The suits have weathered their first major legal challenge and the plaintiffs are requesting class-action status.
By Heather Caspi • May 29, 2015 -
Why one hospital may lose its Medicare funding
CMS could terminate the hospital from the program as soon as June 5.
By Nina Flanagan • May 28, 2015
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