Payer: Page


  • IRS announces 4.3% PCORI fee increase

    The fee will apply to policy and health plan years that end from Oct. 1, 2015 to Oct. 1, 2016.

    By Oct. 14, 2015
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    Texas insurers, providers engage in balance billing battle

    While industry groups blame each other, advocates say the blame is shared.

    By Heather Caspi • Oct. 14, 2015
  • Explore the Trendline
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    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
  • Kentucky Health Co-op closing due to financial hardships

    Close to 51,000 members will have to find other insurance by Dec. 31. 

    By Nina Flanagan • Oct. 13, 2015
  • AHIP surveys find 'Cadillac tax' a drag on employers

    Employers add their thoughts to the Cadillac tax discussion. To no surprise, it's not favorable.

    By Oct. 13, 2015
  • 15M uninsured individuals eligible for Medicaid or subsidized coverage

    A Kaiser Family Foundation report provides state-level data on people without insurance who are eligible for Medicaid or subsidized ACA coverage, and on those who are ineligible.

    By Oct. 13, 2015
  • Gov. Brown signs bill to cover illegal children with health insurance

    In addition, New York City plans to expand low-cost healthcare to uninsured immigrants under a pilot program next year.

    By Nina Flanagan • Oct. 13, 2015
  • CMS star ratings show mix of Medicare Advantage plan quality

    More Medicare Advantage plans earned 4 stars showing private insurers are trying to meet federal standards. 

    By Nina Flanagan • Oct. 13, 2015
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    Deep Dive

    Home healthcare at the crossroads as market expands

    More at-home care plans are providing better care and reducing costs but are insurers ready to reimburse for such services?

    By Nina Flanagan • Oct. 13, 2015
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    Deep Dive

    Programs go beyond health in pursuit of wellness

    Education assistance, financial health and more can be expected to appear in wellness programs.

    By Heather Caspi • Oct. 13, 2015
  • AHA calls for passage of SMARTER Act

    The bill aims to level the playing field for efforts toward hospital integration and realignment.

    By Heather Caspi • Oct. 12, 2015
  • US spending more on healthcare but faring worse than peer nations

    The U.S. is paying more but not getting more, researchers at The Commonwealth Fund say.

    By Heather Caspi • Oct. 12, 2015
  • Obama signs ACA small employer tweak

    Republicans and Democrats played nice to update the healthcare law.

    By Heather Caspi • Oct. 9, 2015
  • CMS announces 'encouraging' results from CPC initiative

    The results suggest payments may be helping providers improve care coordination.

    By Heather Caspi • Oct. 9, 2015
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    House to create special committee for Planned Parenthood investigation

    The impact could reverberate far beyond Planned Parenthood, given the scope of the committee's authority.

    By Heather Caspi • Oct. 9, 2015
  • Bill would ban Advantage plans from cutting providers mid-year

    Sen. Sherrod Brown (D-OH) accuses insurers of "blatant bait and switch" when they reduce networks after enrollment.

    By Heather Caspi • Oct. 9, 2015
  • CMS releases massive data set on durable medical equipment costs and services

    In total, the data represent over 100 million claims and $11 billion in Medicare allowed amounts.  

    By Oct. 8, 2015
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    Study finds complex patients tend to switch out of Medicare Advantage

    The results and responses raise questions about Medicare Advantage serving patients with complex care needs. 

    By Nina Flanagan • Oct. 8, 2015
  • Brown signs first US bill to protect health brokers

    The measure protects brokers from last-minute, unilateral changes to health plans.

    By Oct. 7, 2015
  • NJ hospitals allege incorrect Medicare payments in CMS lawsuit

    The hospitals say CMS incorrectly calculated their payments due to their services under a New Jersey charity program.

    By Heather Caspi • Oct. 7, 2015
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    Harvard Pilgrim Health Care partners to create population health company

    Benevera Health is set to begin operations on Jan. 1, 2016.

    By Heather Caspi • Oct. 7, 2015
  • Oscar expanding into Texas and California in 2016

    The industry disruptor is moving beyond its New York/New Jersey roots.

    By Heather Caspi • Oct. 7, 2015
  • ACA plan premiums rising an average of 4.4% in 14 cities

    The Kaiser Family Foundation is tracking and updating premium data as it becomes available.

    By Heather Caspi • Oct. 7, 2015
  • Study finds ACA may shift claims from insurers to workers' comp carriers

    In a move that could cost "hundreds of millions of dollars," the fee-for-service model of workers' compensation is providing case-shifting incentives.

    By Heather Caspi • Oct. 7, 2015
  • Deep Dive

    Wellness programs due for privacy scrutiny, experts say

    As the popularity of wellness programs spikes, people are asking what they do with all the data.

    By Heather Caspi • Oct. 7, 2015
  • Health Affairs: Plans for chronically ill cost more with Obamacare than employer

    “The most popular Marketplace plan—the silver plan—has significantly higher cost sharing than does a typical employer-sponsored plan.”

    By Oct. 6, 2015