Enrollment numbers, King v. Burwell pull hospitals in two directions

Despite positive numbers from the second enrollment period, uncertainty about the future of marketplaces makes it difficult for hospitals to plan.

By Julie Henry • March 16, 2015

Tufts, nonprofit network launch NH health plan

The partnership is said to be a first of its kind for the state.

By Heather Caspi • March 13, 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

CMS seeks to tame 'outliers' in preferred Part D drug plans

A new report reveals that independent pharmacies have contacted CMS to complain about inadequate access to in-network pharmacies.

By Anne Zieger • March 12, 2015

CBO: Obamacare costs less than projected

8 million fewer people are expected to gain coverage than originally estimated.

By Heather Caspi • March 11, 2015

Health plans rank higher in customer satisfaction in 2014

The key: Members who "strongly agree" that their health plan is a trusted partner show the highest satisfaction.

By Heather Caspi • March 11, 2015

Oregon payers, hospitals team up on price transparency initiative

Collaboration with insurers is part of the plan to help patients understand their costs in advance.

By Heather Caspi • March 11, 2015

Study: Twitter predicts health insurance enrollment

Will Twitter prove to be a useful monitoring strategy?

By Heather Caspi • March 11, 2015

UnitedHealth decision sparks debate over payers as 'watchdogs'

The insurer raised some eyebrows recently when it announced that it will require special approval for certain types of inpatient hysterectomies. 

By Heather Caspi • March 11, 2015

Report: Swing beds bring in billions for rural hospitals

Will the new HHS findings put increased scrutiny on critical access hospitals?

By Julie Henry • March 11, 2015

CMS launches 'Next Generation' ACO model

The new model will have four payment systems and two risk tracks, including one that is "essentially near 100% risk."

By Katie Bo Williams • March 10, 2015

Legislation aims to tie ACA subsidies to local cost of living

One formula doesn't fit all when it comes to making health insurance "affordable," some legislators say.

By Heather Caspi • March 10, 2015

New bill aims to protect wellness programs from Equal Employment office

"Among the things the commission looks for: Does a wellness plan that rewards one participant also 'punish' another?"

By Heather Caspi • March 6, 2015

AMA and 99 other groups seek ICD-10 backup plan

The groups say CMS is underestimating the impact the transition will have on the "regulatory tsunami" already affecting physicians.

By Heather Caspi • March 6, 2015

Anthem refuses cyber vulnerability scans

Anthem has refused the OIG's voluntary security assessment for the second time since 2013.

By Heather Caspi • March 6, 2015

New UnitedHealthcare app to pay for healthy living

The tool is partially intended to introduce members to UnitedHealthcare's pricing and mobile payment app.

By Katie Bo Williams • March 5, 2015

Survey: Nontraditional operational outsourcing on the rise

The development and management of new value-based payment models is among the functions that many payers plan to outsource.

By Heather Caspi • March 4, 2015

Aetna claims yoga classes are worth $3K per employee each year

CEO Mark Bertolini believes the classes have boosted productivity dramatically. 

By Heather Caspi • March 4, 2015

Maryland considers stop-loss insurance rise

Some payers see the bill as an attempt by dominant CareFirst to protect its market share. 

By Heather Caspi • March 4, 2015

Are insurers missing the boat on SEPs?

Insurers should be prepared for the growing role of special enrollment periods under the ACA.

By Heather Caspi • March 4, 2015

Study: The 4 major hospital rating systems contradict one another

The systems are so inconsistent that very few hospitals got comparable ratings across all four.

March 4, 2015

BCBSNC posts first financial loss since 1999

The company blames its results on the ACA, but says this was not a surprise. 

By Heather Caspi • March 3, 2015

Sign-ups open for CMS Network to discuss payment overhaul

The agency says there will only be incentive for payment reform if "a critical mass of payers" align their efforts.

By Heather Caspi • March 3, 2015

United patients to receive benefits during negotiations with Carolinas Healthcare

If the contract expires, it will affect 12 hospitals and many doctors offices serving almost 80,000 members. 

By Julie Henry • March 2, 2015

Report: Primary care docs opting out of Medicaid as enrollment grows

What are the main reasons for the decline in participation? 

By Julie Henry • March 2, 2015

Aetna accuses Texas hospital of kickback and billing schemes

The high-end hospital in turn accuses Aetna of suing out-of-network providers to coerce them into unfair contracts.

By Heather Caspi • Feb. 27, 2015