Payer: Page 219
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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 -
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 -
Explore the Trendlineâž”
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 -
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 Anne Zieger • Oct. 9, 2014 -
Deep Dive
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 -
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 -
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 Katie Bo Williams • 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 -
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 -
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 Katie Bo Williams • 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 -
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 Anne Zieger • Oct. 6, 2014 -
Deep Dive
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 -
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 -
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 -
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 -
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 Katie Bo Williams • Oct. 3, 2014 -
Hartford Healthcare, Anthem to go their separate ways
After the split, state officials call for clearer heads and a return to bargaining.
By Tammy Worth • Oct. 2, 2014 -
Rural, critical access hospitals left out of ACA provisions
Rural providers were excluded from certain provisions to protect revenue, but can they still find ways to take part?
By Tammy Worth • Oct. 1, 2014 -
Another judge rules against ACA subsidies
This third ruling highlights the partisanship of this issue, one that will likely have to be decided by the Supreme Court.
By Tammy Worth • Oct. 1, 2014 -
North Shore-LIJ to offer coding services
The provider plans to help others prep for ICD-10 conversion.
By Tammy Worth • Sept. 30, 2014 -
Deep Dive
AHIMA recap: ONC lays out interoperability strategy
In a Monday conference session, the ONC's Chief Science Officer discussed the agency's goals surrounding meaningful use and "the Learning Healthcare System."
By Katie Bo Williams • Sept. 30, 2014 -
South Dakota to vote on narrow networks
If the legislation passes, South Dakota will be the 28th state to have some form of "willing provider" law—something the FTC opposes.
By Judy Packer-Tursman , Tammy Worth • Sept. 30, 2014
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