Payer: Page 217
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Pioneer ACO health system kicks off new commercial ACO
Despite having been burned in the Pioneer program, a Maine health system has decided to launch the state's largest commercial ACO with the state's largest health insurer.
By Anne Zieger • Nov. 12, 2014 -
Some Pioneer ACOs to solicit enrollment
If beneficiaries enroll voluntarily, are they more likely to seek care within the ACO's provider network?
By Katie Bo Williams • Nov. 11, 2014 -
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 -
Anthem Blue Cross reveals member information in emails
It is unclear at this time whether or not the incident will require a breach notification.
By Katie Bo Williams • Nov. 11, 2014 -
HHS drops enrollment estimates
The agency's numbers are significantly lower than the most recent Congressional Budget Office estimates.
By Katie Bo Williams • Nov. 10, 2014 -
RWJF: Insurance rates flat or decreasing in many states
The new study appears to back up the theory that increasing competition in the exchange marketplaces will drop premiums across the board.
By Katie Bo Williams • Nov. 10, 2014 -
Supreme Court to take subsidy case
If the Court rules in favor of the plaintiffs, the decision could wreak havoc on the structure of the Affordable Care Act.
By Katie Bo Williams • Nov. 7, 2014 -
Largest US pharma benefits manager may seek alcohol/tobacco-free network
Express Scripts has been keeping a close eye on CVS Caremark's anti-tobacco crusade.
By Nicole Gray • Nov. 6, 2014 -
Health center operator, patient recruiter jailed for $258M in Medicare fraud
Leveraging partial hospitalization programs for Medicare fraud seems to be an emerging trend.
By Katie Bo Williams • Nov. 6, 2014 -
OIG audits to target Medicare Advantage plans
Specifically? Risk inflation.
By Katie Bo Williams • Nov. 5, 2014 -
New HHS guidance: Employer health plans must cover inpatient services
A previous loophole in the Affordable Care Act allowed self-insured employers to design "skinny" plans without hospitalization coverage.
By Katie Bo Williams • Nov. 5, 2014 -
Study: Extra day in hospital may save lives, cut long-term costs
Readmissions cost almost $17 billion annually. This new study suggests longer stays can significantly reduce that.
By Randy Lilleston • Nov. 4, 2014 -
MA, Obama administration strike 5-year Medicaid waiver deal
The state administration praised the length and size of the deal—although the level of funding provided was lower than they had originally requested.
By Sy Mukherjee • Nov. 4, 2014 -
Aetna shores up private exchange business with $400M purchase
The cash purchase allows Aetna to continue to position itself as a benefits administrator.
By Katie Bo Williams • Nov. 3, 2014 -
Will Medicare begin paying for end-of-life counseling in 2016?
The administration is considering it. Cue the political debate.
By Katie Bo Williams • Nov. 3, 2014 -
Medicare telehealth payments to rise in 2015
The American Telemedicine Association still did not get everything it asked for in the new 2015 payment rules.
By Katie Bo Williams • Nov. 3, 2014 -
Supreme Court will not hear ACA subsidy case (at least for now)
What happens next?
By Katie Bo Williams • Nov. 3, 2014 -
Medicare paying for drugs for the dead
Medicare's policy of paying for prescriptions filled up to 32 days after a patient's death may have cost the agency millions and fueled the black market for costly drugs.
By Anne Zieger • Nov. 3, 2014 -
Insurer uses communication pilot to reduce malpractice suits
The California-based insurer is hoping that a simple digital health tool will help reduce orthopedic claims.
By Tammy Worth • Nov. 3, 2014 -
Study: How is the ACA being advertised?
The ACA has generated an unprecedented volume of political and health insurance advertising, but despite its volume, it's not clear what impact the ad blitz has had on consumers.
By Anne Zieger • Nov. 3, 2014 -
Deadline today for providers to respond to CMS appeal offer
The agency wants to cut back the backlog of challenged Medicare claims. But will hospitals take the offer?
By Anne Zieger , Katie Bo Williams • Oct. 31, 2014 -
Feds sue vendor and NYC for millions in Medicaid fraud
The Times reports that false diagnosis data was used on more than 600,000 claims totaling $49M in payments in just a four-day period in 2009.
By Tammy Worth • Oct. 31, 2014 -
Arkansas private option in jeopardy
Will the state of Arkansas' version of the Medicaid expansion stay in place? It all depends on a couple of key elections.
By Anne Zieger • Oct. 31, 2014 -
Deep Dive
Supreme Court to discuss today if it will take subsidy case
Experts say the decision to take the case would be an overtly political move.
By Tammy Worth • Oct. 31, 2014 -
Deep Dive
The bottom line: What has the ACA done for hospitals?
26 million citizens are newly insured under the ACA, but what has the overall impact been on the industry?
By Tammy Worth • Oct. 30, 2014 -
Study: Premiums rose dramatically after ACA implementation
But is comparing premiums before and after like comparing applies and oranges?
By Tammy Worth • Oct. 30, 2014
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