Payer: Page 207
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Centene doubles Q1 profit as Medicaid managed care market booms
The company credited huge growth in membership for the spike.
By Katie Bo Williams • April 28, 2015 -
Deep Dive
How tiered-network health plans impact the hospital bottom line
Over a three-year study period, 44% of hospitals switched tiers, mostly due to a decrease in prices.
By Julie Henry • April 28, 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 -
UnitedHealthcare, Carolinas HealthCare reach deal after two-month stalemate
The new contract continues coverage for enrollees at the Charlotte-area health system.
By Heather Caspi • April 28, 2015 -
Study: EHRs can validate insurance coverage in real time
Leveraging this capability can help with insurance retention, the authors note.
By Julie Henry • April 27, 2015 -
BCBS to open health insurance marketplace for retirees
The exchange will help retirees transition from group plans to individual coverage.
By Julie Henry • April 27, 2015 -
Humana acquires home health provider Your Home Advantage
Regulators have expressed concerns that insurers are using at-home diagnosis to inflate patient risk scores.
By Katie Bo Williams • April 22, 2015 -
Blue Cross Blue Shield of Michigan launches emergency care initiative
The company now has 21 Collaborative Quality Initiatives around the state.
By Heather Caspi • April 22, 2015 -
Deep Dive
The two ways AHIP says medical device regulation is inadequate
The trade group is spearheading efforts toward an improved pre- and post-market biomedical infrastructure.
By Heather Caspi • April 22, 2015 -
UPDATED: Nemours lawsuit seeks $15M from UnitedHealthcare for unpaid bills
The foundation has taken aim at UnitedHealthcare's Medicaid contracts in several states.
By Heather Caspi • April 22, 2015 -
Los Angeles health plan to accept cash payments
The service makes it easier for people without bank accounts to maintain health coverage.
By Heather Caspi • April 22, 2015 -
BCBS of Massachusetts approves previously-disputed double mastectomies
The insurer says its denial of eight procedures was a matter of confusion, but the incident has raised questions about whether it overstepped.
By Heather Caspi • April 21, 2015 -
Value of health plan startup Oscar skyrockets to $1.5B
"Now we feel ready to expand our products to other states," said founder Joshua Kushner.
By Julie Henry • April 21, 2015 -
CMS releases data on reinsurance contributions, issues rate filing date
The agency did not hit ACA guidelines for reinsurance contributions.
By Julie Henry • April 20, 2015 -
Equal Employment office issues guidance on wellness programs
The proposed rule addresses concerns that wellness programs could be discriminatory or non-voluntary.
By Heather Caspi • April 17, 2015 -
CMS proposes 1.4% rate increase for skilled nursing facilities
The increase matches the 2014 hike, but is a drop from the $750-million boost that SNFs received in 2015.
By Katie Bo Williams • April 16, 2015 -
Vermont in limbo over large businesses entering exchange
Following the failure of the state's single-payer plan, questions remain about how to move forward.
By Heather Caspi • April 15, 2015 -
Study: Narrow networks proving popular cost-savers
New McKinsey Center data suggests narrow plans have overcome early criticism.
By Heather Caspi • April 15, 2015 -
HHS denies special enrollment for pregnant women
The agency says it is taking its cue from the private insurance industry.
By Heather Caspi • April 15, 2015 -
Deep Dive
Do employee health enrollees care about cost?
A new survey suggests that "we have a really long way to go to create the consumer mindset that the industry has been trying to create now for 10 or 15 years."
By Heather Caspi • April 15, 2015 -
UnitedHealth, Walgreens pilot rewards program
The collaboration encourages simple "micro-habits" that can lead members toward healthier choices.
By Heather Caspi • April 14, 2015 -
'Angelina Effect' increases demand for genetic testing
Some major insurers are refusing coverage, claiming the tests are unproven.
By Julie Henry • April 14, 2015 -
Feds allow providers to dispute Open Payments
Payments that are disputed but not resolved within 15 days after the review period will be made public on June 30.
By Julie Henry • April 13, 2015 -
Brand familiarity, not star ratings, important in senior selection of BCBS Medicare plans
...but many consumers are also not aware that Blue Cross Blue Shield is not a single company.
By Julie Henry • April 13, 2015 -
UPMC warns it will cut off Highmark Medicare Advantage policyholders
Pennsylvania Gov. Tom Wolf called UPMC's decision "unacceptable." UPMC says Highmark owes it $143 million.
By Heather Caspi • April 10, 2015 -
Former VP files wrongful termination suit against Blue Shield of California
The executive says he was fired after blowing the whistle on financial improprieties.
By Heather Caspi • April 10, 2015
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