Payer: Page 216


  • Why UnitedHealth's Q3 profits beat expectations

    The insurer's strong quarterly profits stem from Medicaid growth, Optum revenue—​and low medical spending.

    By Tammy Worth • Oct. 17, 2014
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    Health insurance payments going digital

    Providers have several choices in how they accept payments from health insurers, each with its own problems. Eventually, it will all go digital, speeding up the process significantly, one expert says. 

    By Oct. 17, 2014
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    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
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    Private Kansas Medicaid insurers lose $73M in six months

    Three health plans administering the Kansas Medicaid plan are on pace for an annual shortfall which could exceed the $110 million lost on the program in 2013.

    By Oct. 14, 2014
  • Pharma sues feds, again, over 340B hospital orphan drug discount rule

    The battle between pharma and the federal government over a controversial 340B drug discount program rule rages on.

    By Sy Mukherjee • Oct. 13, 2014
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    Collecting ahead of time: Turn-off or life saver?

    Hospitals' total cost of uncompensated care reached $46 billion as of 2012—equal to about 6% of expenses.

    By Oct. 13, 2014
  • Deep Dive

    Healthcare reform: Then and now

    A year after implementation of major provisions of the ACA, healthcare has been turned upside down.

    By Tammy Worth • Oct. 13, 2014
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    Exchange enrollee med use tracked

    Over half of the drugs prescribed in public plans were for HIV as opposed to 20% through employers.

    By Tammy Worth • Oct. 10, 2014
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    AMA study finds lack of competition in insurance markets

    17 states had a single insurer with 50% or more of the market share; 45 states had only two. 

    By Tammy Worth • Oct. 10, 2014
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    Will the feds put an end to narrow networks?

    HHS is considering mandating that public exchange plans conform to the same rules as Medicare Advantage plans.​

    By Tammy Worth • Oct. 9, 2014
  • Blue Cross refuses to negotiate with hospital affiliations

    Will the insurer's decision make it more difficult for smaller organizations to remain independent through affiliations?

    By Tammy Worth • Oct. 9, 2014
  • Medicare outpatients pay higher tab at critical access hospitals

    Medicare pays critical access hospitals more for services, but due to a twist in billing policy, patients often pay more out of pocket.

    By Oct. 9, 2014
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    Will Vivity succeed where traditional ACOs have failed?

    Some doubt the unique collaboration would work outside of California without competition from Kaiser. What about in SoCal?

    By Tammy Worth • Oct. 9, 2014
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    Supreme Court to decide if providers can sue Medicaid for higher rates

    A group of Idaho providers say that the only way they could keep reimbursements at a sustainable level was through a lawsuit. 

    By Tammy Worth • Oct. 8, 2014
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    New Medica narrow network plan relies exclusively on Mayo

    According to Mayo, this partnership is "one of the first times" that the system has participated in a narrow network plan.

    By Oct. 8, 2014
  • Confidential testing of Healthcare.gov begins

    Insurers are now allowed on the site to test for the November launch but their results won't be reported.

    By Tammy Worth • Oct. 8, 2014
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    Will Congress allow funding for community health centers to expire?

    Community centers received $3.5 billion in federal funding this year alone, but the program is slated to end at the end of the fiscal year.

    By Tammy Worth • Oct. 7, 2014
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    Anthem, Hartford HealthCare sign 11th-hour contract

    The agreement will augment the accountable care arrangement between the two companies.  

    By Tammy Worth • Oct. 7, 2014
  • Wal-Mart deepens healthcare involvement, offers insurance on-site

    Wal-Mart will roll out counters in 2,700 stores nationwide where consumers can talk with insurance agents about plan options and enroll in-store.

    By Oct. 6, 2014
  • GAO: Congress must approve HHS risk corridor appropriations

    The general counsel for the Government Accountability Office said that while the ACA created the risk corridor provision, there was no language in the legislation to enact an appropriation.

    By Tammy Worth • Oct. 6, 2014
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    Aetna creates large Northern California ACO

    Aetna's Banner Health ACO created $5 million in shared savings; Will the insurer be able to replicate that success in this market?

    By Oct. 6, 2014
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    4 challenges to value-based care

    The importance of paying for value instead of volume seems clear... but can hospitals survive the transition? 

    By Tammy Worth • Oct. 6, 2014
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    Geisinger uses telemedicine to improve outcomes, reduce cost

    Patients using telemonitoring tools saved the health plan about $216 per patient each month.

    By Tammy Worth • Oct. 6, 2014
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    HHS sued over 2015 rate disclosures

    A former attorney overseeing ACA implementation alleges that HHS is not living up to the law.

    By Tammy Worth • Oct. 3, 2014
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    Medicare levies readmission fines against record number of hospitals

    More than 2,500 hospitals will feel the pinch of higher fines on more conditions.

    By Tammy Worth • Oct. 3, 2014
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    Deep Dive

    The Friday Dive: Industry reactions to RAC figures mixed

    Healthcare Dive's editor looks back on the biggest news from the last week. 

    By Oct. 3, 2014