UnitedHealthcare considers split with two Connecticut hospitals

A contract dispute appears likely to run up against an April 14 deadline.

By Heather Caspi • March 27, 2015

Highmark delays paying claims, blames state

The insurer argues that a 2014 consent decree created confusion over when Highmark members can be treated at UPMC at in-network rates.

By Anne Zieger • March 26, 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

Cigna and SCAN partner for Medicare Advantage

In day-to-day terms, SCAN will help Cigna move Medicare beneficiaries in California over to Medicare Advantage.

By Anne Zieger • March 26, 2015

UPMC makes 'significant investment' in tech company High Fidelity

The Health Fidelity risk adjustment solution was deployed at UPMC Health Plan last year. 

By Heather Caspi • March 25, 2015

Study: Consumer-driven health plans contain costs

But will reductions be sustained in the long-term?

By Heather Caspi • March 25, 2015

Federal employees to get self-plus-one option in 2016

The proposed rule will likely raise premiums for the family plan.

By Heather Caspi • March 25, 2015

Execs weigh in: 4 ongoing trends prompted by the ACA

Industry sales and M&A are just one way the Affordable Care Act, which turns 5 years old this week, continues to impact payers.

By Heather Caspi • March 25, 2015

Blue Shield of California loses bid for secrecy in $1.25B acquisition

The insurer wanted to keep quiet on the amount it is paying for Care1st.

By Heather Caspi • March 25, 2015

Diabetes diagnoses spike in Medicaid expansion states

A new study suggests that expansion of coverage to vulnerable groups can impact population health and the cost of chronic disease management.

By Heather Caspi • March 24, 2015

Humana to sell Concentra for $1B

"...Concentra's operations did not ultimately align with Humana's strategy as well as we had originally anticipated," said CEO Bruce Broussard. 

By Katie Bo Williams • March 23, 2015

Audit warned Premera of vulnerabilities before breach

The company received the audit just weeks ahead of the cyberattack.

By Heather Caspi • March 20, 2015

Anthem yet to notify 50M customers of cyberattack

Key senators are strongly criticizing the company for the delay.

By Heather Caspi • March 20, 2015

Blue Cross, WebMD partner for digital health

"Employers know the value of wellness programs, and how the right program can... help better manage overall health care costs," Blue Cross says. 

By Anne Zieger • March 19, 2015

Blue Shield of California loses tax-exempt status

The insurer has faced increased criticism over its enormous financial reserves.

By Katie Bo Williams • March 18, 2015

Starwood Hotels selects private exchange to serve 26,500 employees

The company joins a number of other major employers that have also transitioned to private exchanges over the last few years.

By Heather Caspi • March 18, 2015

The future of health insurance retail stores

"This shift toward a consumer-centric model is going... to increase demand in brick-and-mortar retail stores," said one expert. 

By Heather Caspi • March 18, 2015

Feds keep wraparound coverage essentially as-is

The final rule clarifies the allowable roles of excepted benefits.

By Heather Caspi • March 18, 2015

Premera Blue Cross breach exposes 11M

Healthcare security expert Dave Kennedy told Reuters that this is the largest breach to date involving medical information.

By Katie Bo Williams • March 17, 2015

Covenant projects $1.8M in savings using data-driven health plans

The nonprofit is using MedeAnalytics' Population Health solution to gain insights into its 7,000 employees and beneficiaries.

By Heather Caspi • March 17, 2015

Florida feels the heat on Medicaid expansion issue

The state may be the first to come under strategic pressure from the federal government.

By Heather Caspi • March 17, 2015

Aetna, others push to incorporate UDIs into medical claims

CMS is against the requirement, but Aetna's CMO says transparency is necessary to improve quality of care.

By Julie Henry • March 17, 2015

Sources reveal feds' alleged ACA contingency plan

Two sources have told Forbes that Plan B is to ask states to declare they are subcontracting their exchanges to HHS. But would SCOTUS allow it?

By Heather Caspi • March 17, 2015

Next Generation model designed for experienced ACOs

Healthcare Dive takes a deeper look at CMS' new accountable care organization model—and how providers can benefit. 

By Julie Henry • March 17, 2015

HHS: Affordable Care Act has caused 'historic' reduction in uninsured

Officials say the percentage of people without health insurance coverage has dropped by around 33% since 2012. 

By Julie Henry • March 16, 2015

BCBS of MA to expand use of global budgets to PPOs

Many providers believe the move may end up costing them and are hesitant to commit. 

By Julie Henry • March 16, 2015