Payer: Page
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Insurers and non-profit create tool to open up cost data
The online portal represents an unprecedented partnership between Aetna, Humana and UnitedHealthcare and the Health Care Cost Institute. But will consumers use it?
By Anne Zieger • May 14, 2014 -
JAMA: Medicare spent $8.5B on needless care
Researchers analyzed claims data based on evidence-based lists of services that provide minimal clinical benefits.
By Anne Zieger • May 13, 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 -
Medicare demands Robert Packer Hospital refund $1.9M
According to Medicare, more than a third of the examined claims had billing errors — but the hospital plans to appeal.
By Anne Zieger • May 12, 2014 -
Health insurance storefronts popular with consumers
Brick-and-mortars offer personal face-to-face time for customers, which they can't get from an online exchange.
By Anne Zieger • May 12, 2014 -
BCBS of Kansas City breach affects 2,546 members
The incident occurred when an employee inappropriately accessed member information.
By Anne Zieger • May 9, 2014 -
Health plans hiring execs with retail backgrounds
One Humana exec spent more than a decade in senior roles at Target.
By Anne Zieger • May 9, 2014 -
Most health exchange enrollees have paid first premiums
At Aetna, 500,000 out of 600,000 exchange enrollees have made an initial payment — and other insurers are experiencing similar percentages.
By Anne Zieger • May 7, 2014 -
States expanding Medicaid managed care
Florida, Texas and other states that are not expanding Medicaid under the ACA are choosing to expand Medicaid managed care programs instead.
By Anne Zieger • May 6, 2014 -
Mortality plummeted with improved coverage in MA
A study in the Annals of Internal Medicine found that five years after Massachusetts implemented health reform, there was a 4.5% drop in death due to improved access.
By Anne Zieger • May 6, 2014 -
Deep Dive
Does HHS condone charitable premium subsidies or not?
Despite recent pressure from the American Hospital Association and the Catholic Health Association, HHS has not issued any firm guidance on whether hospital-affiliated charitable foundations can offer premium subsidies for marketplace policies — leaving hospitals in the lurch.
By Anne Zieger • May 6, 2014 -
Washington insurers must expand provider networks
Effective in 2015, the rule not only requires insurers to increase plan transparency, but also effectively requires them to broaden their networks for plans sold on the exchanges.
By Anne Zieger • May 5, 2014 -
Gallup: US uninsured rate lowest since 2008
The uninsured rate has consistently declined since it peaked at 18% in the third quarter of 2013, according to Gallup.
By Anne Zieger • May 5, 2014 -
Fortune 500 firms to replace employer plans with exchange plans
Over the next six years, 90% of Fortune 500 companies will switch their health coverage to plans sold on the federal exchange, according to Standard & Poor Capital IQ.
By Anne Zieger • May 5, 2014 -
Despite ACA, Latino community accessing care in Mexico
Though many insurers have promoted their products to the Hispanic consumer market, enrollment has been far below expectations.
By Anne Zieger • May 5, 2014 -
Cigna Q1 profit shoots upward
First quarter net income rose more than 800% while revenue climbed 3.8%, an increase CIGNA attributes to growth in premiums and fees.
By Anne Zieger • May 1, 2014 -
Massachusetts General Hospital to repay $1.2 million to Medicare
According to the HHS Office of the Inspector General, Mass General was in compliance with Medicare billing requirements on only 23% of claims sampled by the organization.
By Anne Zieger • April 30, 2014 -
Deep Dive
4 facts to consider before filing for the Medicare Shared Savings Program
ACOs must determine not only whether they can create savings sufficient to justify enrollment in the short term, but also how they will continue to operate a value-based model after they have maxed out their efficiencies.
By Katie Bo Williams • April 29, 2014 -
Pay-for-performance policies unfair, report suggests
In pay-for-performance programs, providers who treat the poor and uneducated often suffer unintended financial penalties.
By Anne Zieger • April 28, 2014 -
Young adults buying ACA insurance grows
A new study found that there were strong gains in ACA coverage among young adults between Q3 2013 and Q1 2014.
By Anne Zieger • April 25, 2014 -
Aetna CEO: Expect ACA rate hikes
Aetna CEO Mark Bertolini said ad hoc regulatory changes contributed to half of the premium increases.
By Anne Zieger • April 25, 2014 -
Deep Dive
How $8B in Medicaid savings will transform New York health care
Healthcare Dive takes a closer look at the recent influx of cash into New York’s health care system. If the administration's plans work as hoped, the new program will be part of the national shift from fee-for-service to value-based care.
By Anne Zieger • April 25, 2014 -
Physician charged in Orthofix fraud case
A physician has been sentenced in the ongoing Medicare fraud investigation; the charging comes at a time when doctors who bill Medicare are under greater scrutiny than ever.
By Katie Bo Williams • April 25, 2014 -
Consumer-driven health plan members more engaged, less costly
Cigna compared CDHP members with PPO and HMO enrollees and found that, among other metrics, CDHP members were 50% more likely to complete a health risk assessment.
By Anne Zieger • April 23, 2014 -
ACOs require big investment to survive
To succeed in the transition from fee-for-service to value-based care, newly-minted ACOs need to learn from those with experience, such as Geisinger Health System and Kaiser Permanente.
By Anne Zieger • April 22, 2014 -
High-risk pools finally closing down
The temporary pool program is being shut down after three extensions.
By Anne Zieger • April 21, 2014
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