Payer: Page 210
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Medicare assists beneficiaries in Aetna pharmacy muddle
The mix-up has highlighted the need for consumer education.
By Heather Caspi • Feb. 4, 2015 -
Deep Dive
What the consumer tax penalty will mean for issuers
As many as 6 million households may face the first-ever penalty for forgoing health insurance in 2014. How will this affect consumer behavior?
By Heather Caspi • Feb. 4, 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 -
Survey: Value-based Medicare crowds out specialists
One physician claims that doing away with fee-for-service will make physicians "clock-watching salarymen."
Feb. 4, 2015 -
Blue Shield and Sutter end rate dispute, sign deal
The terms of the deal were confidential, but we can glean a few clues.
By Heather Caspi • Feb. 4, 2015 -
Could 'healthcare sharing ministries' scale up?
State regulators are raising concerns that member-based ministries are skirting regulations.
By Marisa Torrieri • Feb. 4, 2015 -
CMS to publish Medicare physician payment data annually
"As imperfect as the data may be, its continued release makes it in the physicians' interest to make it better... instead of just fighting its release," said former Medicare head Gail Wilensky.
By Marisa Torrieri • Feb. 3, 2015 -
UPDATED: Obama's new budget proposes historic, direct drug price negotiations in Medicare
It would be a game-changing shift in an era of high-priced specialty drugs. But does it have any chance of passing a Republican Congress?
By Sy Mukherjee • Feb. 2, 2015 -
Community Health Systems dunned $75M in False Claims suit
The feds allege that CHS engaged in a 10-year scheme that allowed them to receive additional federal dollars through a now-defunct matching program.
By Katie Bo Williams • Feb. 2, 2015 -
Kaiser 'robo-calls' unvaccinated members
The insurer is investing in herd immunity.
By Marisa Torrieri • Feb. 2, 2015 -
As Medicare payments for stents grow, scrutiny follows
A New York Times report questions if some common (and costly) cardiac procedures are really necessary.
By Marisa Torrieri • Feb. 2, 2015 -
Highmark accepts coverage terms for UPMC-Magee
Highmark and UPMC squabbling continues. How much damage will this do to consumer perception of Highmark?
By Marisa Torrieri • Feb. 2, 2015 -
Report: Patient-centered medical homes lower costs
"In order for the PCMH to be sustainable, we need greater investment in primary care and less reliance on the fee-for-service payment system," said funding president Christopher Koller.
By Marisa Torrieri • Feb. 2, 2015 -
Wyoming debates two Medicaid expansion proposals
"I thought [the ACA] was bad policy and I thought it was unconstitutional. The courts said I was wrong," said Gov. Mead. "How do we as a state make the best of it?"
By Heather Caspi • Jan. 30, 2015 -
Anthem Blue Cross puts $38B in value-based contracts
Yet another significant player throws their hat into the value-based reimbursement ring this week.
By Heather Caspi • Jan. 30, 2015 -
Cigna purchases hospital-owned NJ insurer
QualCare oversees self-insured health plans that are known for their tight association with local physicians and hospitals. Will its business model change under Cigna?
By Marisa Torrieri • Jan. 29, 2015 -
Proposed Oct. to Dec. enrollment period puts insurers at a disadvantage
The adjusted enrollment period puts issuers on an abbreviated deadline to submit plans and rates.
By Heather Caspi • Jan. 28, 2015 -
Iowa to liquidate failed CO-OP
The liquidation provides fodder for critics to speculate that this may be the first of many CO-OPs to fail.
By Heather Caspi • Jan. 28, 2015 -
Major private insurers, providers team up to shift to value-based care
The group plans to shift 75% of operations to value-based contracts by 2020. Players include Ascension, Aetna and Partners, among others.
By Katie Bo Williams • Jan. 28, 2015 -
Estimated cost of ACA cut, enrollment grows to 9.5M
Two new reports from the Congressional Budget Office and HHS reveal encouraging numbers about the Affordable Care Act.
By Heather Caspi • Jan. 28, 2015 -
Deep Dive
The limited impact of price transparency on consumer behavior
Price comparisons provide some incentive to consumers, but the impact of cost variation on how they determine value may surprise you.
By Heather Caspi • Jan. 28, 2015 -
Value-based Medicare goals undermined by hazy roadmap
HHS announced Monday that it aims for 50% of Medicare payments to be tied to alternative payment models by the end of 2018.
Jan. 28, 2015 -
Massachusetts insurers challenge risk assessment payments
The state's smaller insurers say flawed data will unfairly force them to buoy big Blue Cross Blue Shield.
By Heather Caspi • Jan. 27, 2015 -
UnitedHealthcare launches physician-led ACO in TX
The move is part of UnitedHealthcare's consistent march toward value-based reimbursement programs.
By Heather Caspi • Jan. 27, 2015 -
Indiana expands Medicaid to 350,000
Another Republican-led state has accepted federal funding to expand the program.
By Katie Bo Williams • Jan. 27, 2015
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