Payer: Page
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GOP, co-op administrators play the blame game over closures
Finger-pointing was widespread at a hearing last week examining the recent failures of about half of the ACA's health insurance co-ops.
By Heather Caspi • Nov. 9, 2015 -
Humana to pull marketplace plans serving 100,000
The plans were attracting higher utilization from sick patients than was expected when they were priced.
By Heather Caspi • Nov. 9, 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 -
CMS loses 2 more Pioneer ACOs, prepares Next Generation model
The program has dropped from 32 participants in 2012 to 16 as of this month.
By Heather Caspi • Nov. 6, 2015 -
Uninsured rate drops to record 9%
A steep decline from 2013 to 2015 has put the nation's uninsured rate in the single digits.
By Heather Caspi • Nov. 6, 2015 -
CMS addresses underpayment for dual-eligibles
The agency has reversed its position following persistent complaints from impacted health plans.
By Heather Caspi • Nov. 6, 2015 -
Humana to pilot telehealth program for elderly in Arizona
Humana will pilot the program in Arizona, Washington, plus 13 additional states.
By Nina Flanagan • Nov. 5, 2015 -
Deep Dive
What you missed at the Health Affairs Food and Health briefing
Here’s what industry experts shared about the new integration between the food and health industries.
By Jeff Byers • Nov. 5, 2015 -
Let's make a deal! California and feds OK $6.2B Medicaid reform agreement
The majority of the funds, $3.3 billion, will go towards helping public hospitals improve safety and quality of patient care.
By Nina Flanagan • Nov. 5, 2015 -
Deep Dive
How much do physicians trust insurance companies?
"Dismal" trust levels could impede risk-based healthcare and payment models.
By Heather Caspi • Nov. 4, 2015 -
UnitedHealth positioned to benefit by others' megamergers
The company could profit from its competitors' growing pains, experts suggest.
By Heather Caspi • Nov. 4, 2015 -
HCA to bury shareholder hatchet for $215M
The 2011 lawsuit to be settled alleged the company used misleading information when making its initial public offering.
By Jeff Byers • Nov. 4, 2015 -
Michigan health co-op to shutter operations
Yesterday, representatives at a contentious House Ways and Means Subcommittee on Health meeting vented their frustrations on why the co-ops are failing.
By Jeff Byers • Nov. 4, 2015 -
SHOP enrollment falls short of expectations
The marketplace for small employers is proving slow to catch on but that isn't bothering the Obama administration.
By Heather Caspi • Nov. 4, 2015 -
Montana becomes 30th state to expand Medicaid
After a three-year battle to achieve a bipartisan compromise, some experts hope more states will follow.
By Heather Caspi • Nov. 4, 2015 -
HealthCare.gov testing whether consumers will use physician search feature
CMS stated a pilot prescription drug check feature will roll out in the coming weeks.
By Jeff Byers • Nov. 3, 2015 -
Health Alliance Plan, HealthPlus Sign like each other so much, they agreed to merge
The merger will establish a company that’s one of the largest health insurers in Michigan.
By Jeff Byers • Nov. 3, 2015 -
New York health co-op forced by government hand to close early
Health Republic Insurance of New York will end all policies on Nov. 30.
By Jeff Byers • Nov. 3, 2015 -
California slaps Blue Shield, Anthem with fines over inaccurate provider directories
“These inaccuracies limited enrollee access to care that resulted in an unacceptable consumer experience and must be fixed.”
By Jeff Byers • Nov. 3, 2015 -
Health Affairs: Severe obesity cost U.S. $69B
Approximately 27% of the cost of severe obesity was paid for by private health plans in 2013.
By Jeff Byers • Nov. 3, 2015 -
With final rule, Medicare to pay for end-of-life consultations
CMS proposed Medicare start reimbursing for end-of-life consults back in July.
By Nina Flanagan • Nov. 3, 2015 -
2016 OPPS rule finalizes two-midnight policy, doesn't take criticism
Hospital admissions lasting less than two midnights can qualify as exceptions to be payable under Medicare Part A.
By Heather Caspi • Nov. 3, 2015 -
CMS to Arizona co-op: No market exchange for you
Meritus, the 11th health cooperative to shut its doors, was reportedly caught off-guard by last week's order for supervision.
By Heather Caspi • Nov. 3, 2015 -
CMS releases final rule on essential services for Medicaid beneficiaries
The provisions aim to enhance meaningful access to healthcare services.
By Heather Caspi • Nov. 2, 2015 -
Nonprofit hospitals poor at informing patients about charity care
A study finds the hospitals "far from perfect" on meeting requirements to tell patients about their options.
By Heather Caspi • Nov. 2, 2015 -
Proposed rule addresses wellness programs' collection of health info
Voluntary programs would be allowed to seek limited genetic information.
By Heather Caspi • Nov. 2, 2015
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