Cigna rejects $175-per-share offer by Anthem: Wall Street Journal

Cigna is one of the most likely candidates to purchase Humana, experts say. 

By Heather Caspi • June 16, 2015

How providers and payers can bridge the disease management gap to cut costs

How can organizations work together to more effectively manage chronic conditions?

By Julie Henry • June 15, 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

PA woman defrauds Highmark to the tune of $600K in prescriptions

Company efforts to combat waste, fraud and abuse "had a financial impact of more than $100 million in 2014," Highmark said in a statement.

By Heather Caspi • June 15, 2015

Express Scripts, insurers press for pay-for-performance drug pricing

But is the pharmaceutical industry on board?

By Heather Caspi • June 15, 2015

CMS pays out $1.3B to hospitals to clear Medicare appeals backlog

RACs say the deal "incentivizes hospitals to continue to overwhelm the system with frivolous appeals."

By Katie Bo Williams • June 15, 2015

Elizabeth Holmes to AHIP meeting: DTC testing is key to health reform

Critics still doubt both the accuracy of Theranos tests and the wisdom of direct-to-consumer testing. 

By Nina Flanagan • June 11, 2015

Independence Blue Cross algorithm that predicts admissions faces privacy concerns

"The healthcare data we provided to build these algorithms is equivalent, I think, to five Wikipedias," CIO Somes Nigam told NPR.

By Heather Caspi • June 10, 2015

Assurant Health closes doors on losses 'significantly worse than anticipated'

The insurer announced in April that it would close its doors if it did not find a buyer. 

By Katie Bo Williams • June 10, 2015

Humana sale: Good for payers, bad for providers?

If a sale is in the works, the Big Four companies may soon be the Big Three. How will consolidation impact the market?

By Heather Caspi • June 10, 2015

California, New York bills would make pregnancy a qualifying event

Bills in two states could allow pregnant women to purchase health insurance outside of the open enrollment period. Would this drive up costs—or reduce them?

By Heather Caspi • June 10, 2015

Humana deadlocked in dispute with HCA hospitals

If no deal is reached by July 10, Florida will feel the impact statewide.  

By Heather Caspi • June 10, 2015

Trinity provider acquires 56-bed GA hospital

The Trinity-owned system will not take on any outstanding debt from the new hospital's recent $62-million construction.

By Heather Caspi • June 9, 2015

Humana pulls out of healthcare conference amid speculation of merger

The Goldman Sachs Global HealthCare conference on Wednesday will carry on without the insurer's CFO. 

By Julie Henry • June 9, 2015

PA announces King contingency plan, but faces time crunch

The state is the first to offer a back-up plan in case residents' ACA subsidies are struck down.

By Heather Caspi • June 5, 2015

New Medicare disclosure reveals additional $12.4B in payments

Although docs who treated fewer than 11 patients overall are still omitted, "the totals displayed in the file are extremely close" to CMS' internal records.

By Heather Caspi • June 5, 2015

TX hospital files $1M suit against big-five insurers over PPO exclusion

Because the three named insurers are the dominant providers of commerical coverage, ETMC is effectively cut out of its entire privately-insured population.

By Nina Flanagan • June 4, 2015

Moody's: Medicaid expansion is not a silver bullet for hospitals

Has the impact of reducing bad debt on hospital bottom lines been overstated?

By Nina Flanagan • June 4, 2015

Anthem saves $8M by paying docs to enhance preventive care

Physicians were paid to provide extra attention to patients with chronic conditions.

By Heather Caspi • June 3, 2015

Anthem announces free college tuition for employees

Employees can now get reimbursed for degrees earned through College for America.

By Heather Caspi • June 3, 2015

The 10 cities where insurers pay the most for medical care—and the least

Hint: The low- and high-cost regions for commercial plans don't correspond with the low- and high-cost regions for Medicare.

By Heather Caspi • June 3, 2015

How Aetna and Massachusetts Blue Cross are leveraging mHealth to lower maternity costs

Maternal and newborn care make up the most expensive category of hospital payouts for most private plans and Medicaid programs. Can the right app move the needle?

By Heather Caspi • June 3, 2015

Highmark closes merger with Blue Cross of Northeastern Pennsylvania

The deal adds over half a million covered individuals across 13 counties to Highmark's existent 4.7 million customers.

By Heather Caspi • June 3, 2015

Will CA become the first state to offer health coverage to illegal immigrants?

The California Senate has cleared a bill that would provide state-subsidized healthcare to illegal immigrants. It heads to the Assembly next. 

By Julie Henry • June 3, 2015

More big insurers seek double-digit rate increases in 2016

Payers with major market share are asking for 15% to 35% increases. 

By Katie Bo Williams • June 2, 2015

GAO report faults use of doctors to set Medicare rates

Are physician groups biased in their recommendations?

By Heather Caspi • June 2, 2015