Payer: Page 230
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Illinois hospitals fined $16.3M for excessive readmissions
...but not by CMS. Safety nets and academic medical centers fared the worst on readmission rates.
By Katie Bo Williams , Tammy Worth • Sept. 9, 2014 -
Feds requiring Medicaid programs to expand autism coverage
Some states are worried not only because they will be required to cover more services for autistic children, but also because there is a large increase in eligible children.
By Anne Zieger • Sept. 8, 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 -
Nearly $25B paid to providers for Meaningful Use
Providers cashed out during Meaningful Use Stage 1. Stage 2, not so much.
By Tammy Worth • Sept. 5, 2014 -
Highmark sues UPMC for padding oncology bills
Pennsylvania's dominant insurer alleges that the provider has engaged in improper billing practices since 2010—to the tune of $300 million.
By Tammy Worth • Sept. 5, 2014 -
Deep Dive
The Friday Dive: Halbig case to go to en banc review
Healthcare Dive's editor looks back on the biggest news from the last week.
By Katie Bo Williams • Sept. 5, 2014 -
Philadelphia health systems and dominant area insurer form ACO
Are there lessons for other ACOs?
By Anne Zieger • Sept. 4, 2014 -
Legislation targets narrow networks in California
The bill follows lawsuits claiming Anthem Blue Cross and Blue Shield misguided consumers regarding provider network size.
By Tammy Worth • Sept. 4, 2014 -
Deep Dive
AMA recommends Medicare reimbursement for advanced care discussions
CMS will make a decision in the fall. How can providers prepare?
By Tammy Worth • Sept. 4, 2014 -
Report: Medicare spending slows for the first time in decades
...but will it last? That depends on who you ask.
By Katie Bo Williams , Tammy Worth • Sept. 4, 2014 -
Auto-enrollment rule finalized
Enrollees who don't return to Healthcare.gov to shop for a new plan will be auto-enrolled in the same plan next year.
By Katie Bo Williams • Sept. 3, 2014 -
Is the Pioneer ACO program on the skids?
Will those providers that stay involved find it easier to work with CMS than the pioneers of the Pioneer program? Or is the program too flawed to survive?
By Anne Zieger • Sept. 3, 2014 -
Medicaid expansion: Who's next?
Which other states have submitted expansion plans to CMS?
By Tammy Worth • Sept. 3, 2014 -
94K in Florida could lose coverage
Florida is a microcosm for a national problem.
By Anne Zieger , Katie Bo Williams • Sept. 2, 2014 -
Healthcare groups oppose new CMS rating system
Some providers hope to shoot down agency plans to rate them on a five-star scale.
By Anne Zieger • Sept. 2, 2014 -
Will Premier's decision to sell insurance pay off?
Over a quarter of hospitals expect to launch their own plans over the next five years. Is this a risk or a smart move?
By Katie Bo Williams , Tammy Worth • Aug. 29, 2014 -
Deep Dive
The Friday Dive: Pennsylvania becomes 27th state to expand Medicaid
Healthcare Dive's editor looks back on the biggest news from the last week.
By Katie Bo Williams • Aug. 29, 2014 -
Washington slashes exchange rates, doubles plans
The state insurance commissioner called the record-low rate changes a "clear sign that health reform is working."
By Katie Bo Williams • Aug. 29, 2014 -
Aetna, Banner Health ACO saves $5M
Was the ACO successful because of its regional model, and did it improve outcomes as well as curb costs?
By Katie Bo Williams • Aug. 28, 2014 -
Deep Dive
How some NJ hospitals are making insurers pay through the nose
A drafting loophole in a state insurance regulation has given some hospitals the chance to turn providing out-of-network care into a money-making enterprise.
By Katie Bo Williams • Aug. 28, 2014 -
CVS announces affiliation with MedStar Health
What are the benefits to MedStar? And just how big is the CVS affiliate footprint?
By Katie Bo Williams • Aug. 27, 2014 -
Marketing expert named new Healthcare.gov CEO
Kevin Counihan has some serious marketing chops, but can he translate a track record of state-level success to the federal level?
By Tammy Worth • Aug. 27, 2014 -
Another Pioneer ACO bites the dust
Is the program's "one-size-fits-all" approach to payment to blame?
By Katie Bo Williams • Aug. 26, 2014 -
Deep Dive
What consumers do and don't know about the ACA, in charts
...and how does that impact support for the law?
By Katie Bo Williams • Aug. 26, 2014 -
Providers have serious concerns about CMS renal ACO program
Is the agency providing sufficient guidance to providers—and are providers applying for the program?
By Katie Bo Williams • Aug. 26, 2014 -
CHS breach could cost up to $100 million
But the greatest cost of the hack is likely to be to the healthcare system at large.
By Katie Bo Williams • Aug. 25, 2014
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