Payer: Page 41
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Robert Riney will lead Henry Ford Health
The new CEO and president has worked in almost “every operating unit in the organization” since he joined in 1978, according to a statement.
By Sydney Halleman • Sept. 8, 2022 -
Justin Sullivan / Staff via Getty Images
Texas judge says HIV drug coverage requirement violates religious freedom
Texas Judge Reed O’Connor once again ruled against the Affordable Care Act. The health law requires employers to purchase insurance coverage that includes coverage for PrEP medication.
By Samantha Liss • Sept. 7, 2022 -
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 -
Physician groups urge CMS to prevent payment cuts, protect telehealth
Multiple groups representing doctors oppose Medicare payment reductions at a time when physician practices face escalating costs.
By Susan Kelly • Sept. 7, 2022 -
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Walmart, UnitedHealth ink 10-year collaboration deal on value-based care
Ultimately, the goal is to serve hundreds of thousands of seniors and Medicare beneficiaries in value-based arrangements through multiple Medicare Advantage plans.
By Rebecca Pifer • Sept. 7, 2022 -
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Molina, Elevance nab Iowa Medicaid contracts on heels of California win
Iowa will soon have three health insurers to manage its $7 billion Medicaid program.
By Rebecca Pifer • Sept. 1, 2022 -
Courtesy of Oscar Health
Oscar loses big tech customer amid platform implementation snags
Health First’s decision to terminate their agreement — Oscar’s first full-service tech deal — will cause the insurtech to lose out on up to $60 million in revenue this year.
By Rebecca Pifer • Aug. 31, 2022 -
Courtesy of Scan Group
Q&AScan Group’s deal-maker, Binoy Bhansali, dishes on the importance of creating ‘competitive moats’ to accelerate growth
The vice president of corporate development explains the strategy behind the group's latest investments and how it will help the insurance unit compete in the long term.
By Samantha Liss • Aug. 31, 2022 -
Permission granted by Cigna
Bush appointee tapped as Cigna’s first chief health officer
David Brailer is a founder and chairman of Health Evolution Partners, a healthcare investment firm, and is also vice chairman of the Duke-Margolis Health Policy Center.
By Hailey Mensik • Aug. 30, 2022 -
Retrieved from National Union of Healthcare Workers on August 17, 2022
California probes Kaiser over enrollee access to mental health appointments
The investigation comes as a strike by therapists over staffing issues at Kaiser facilities in Northern California enters its third week.
By Susan Kelly • Aug. 29, 2022 -
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Biden administration makes record-high investment in ACA navigators
The administration is pouring almost $100 million into organizations that help consumers navigate enrolling in Affordable Care Act plans in 2023.
By Rebecca Pifer • Aug. 29, 2022 -
Julia Rendleman via Getty Images
Cigna expanding ACA footprint to 3 new states in 2023
The expansion comes a little over a week since President Joe Biden signed a law extending subsidies for coverage and subsequently creating more stability in the exchanges.
By Rebecca Pifer • Aug. 29, 2022 -
Leon Neal via Getty Images
OpinionCongress finally eliminates Part D vaccine cost sharing: Medicare coverage is still broken
The Inflation Reduction Act leaves intact a peculiar split in Medicare vaccine coverage that discourages physicians from offering certain vaccines, argues former Moderna Vice President Richard Hughes.
By Richard Hughes • Aug. 26, 2022 -
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Molina, Elevance, Centene win big with Medicaid contracts in California
The managed care organizations already held Medicaid contracts with the state, but the overhaul in counties served is causing one payer to consider appealing the proposed contracts.
By Rebecca Pifer • Updated Aug. 29, 2022 -
Healthcare cost growth trails overall price hikes amid record inflation
Prices in the U.S. economy grew 8.5% in July compared to last year, while prices for medical care increased just 4.8%, according to a tracker from the Kaiser Family Foundation and Peterson Center on Healthcare.
By Hailey Mensik • Aug. 25, 2022 -
Drew Angerer/Getty Images via Getty Images
Overturning of Roe v. WadeJudge blocks part of Idaho law, allowing physicians to perform abortions in emergencies
The ruling sides with the Biden administration, delivering a partial win for the DOJ in its first legal challenge since the Supreme Court ruled to overturn the constitutional right to an abortion.
By Samantha Liss • Aug. 25, 2022 -
Sarah Silbiger / Stringer via Getty Images
Medicare Advantage lobby rebuts senator’s inquiry into ‘potentially deceptive’ marketing tactics
The Better Medicare Alliance is arguing that marketing materials for MA plans are already subject to “careful regulation” and adhere to a 53-page set of federal guidelines.
By Rebecca Pifer • Aug. 24, 2022 -
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4 California healthcare organizations reach $71M False Claims settlement
The organizations allegedly pocketed Medicaid adult expansion program funds meant to be returned to the state, according to a DOJ release.
By Hailey Mensik • Aug. 23, 2022 -
15M Medicaid enrollees risk coverage loss when COVID-19 health emergency ends, HHS reports
A disproportionate number of those who stand to lose coverage are children and young adults, according to the agency.
By Susan Kelly • Aug. 23, 2022 -
John Moore / Staff via Getty Images
Surprise BillingFederal regulators nix contested language in surprise billing final rule
The final rule removes the earlier requirement that arbiters must first presume that the median in-network rate is the appropriate payment.
By Samantha Liss • Aug. 22, 2022 -
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CMS aims to mandate state quality reporting for Medicaid, CHIP
The proposed rule would require states to report on quality measurements for the two growing programs for the first time.
By Susan Kelly • Aug. 22, 2022 -
Employer health costs expected to rise 6.5% next year, report finds
The rise is predicted to outpace the prior increase of 3.7% growth in employer costs between 2021 and 2022. Though it is expected to remain below the Consumer Price Index, a figure reflecting inflation.
By Hailey Mensik • Aug. 18, 2022 -
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OpinionThe promise of payer transparency
A new price transparency rule lends itself to creating a more equitable, cost-effective market for medical coverage, Clarify Health chief analytics and privacy officer Niall Brennan argues.
By Niall Brennan • Aug. 17, 2022 -
Joe Raedle/Getty Images via Getty Images
Slowing economy could ding insurers, Moody’s says
A slowdown in the economy may result in job losses and clip commercial enrollment, which would push down a key earnings driver for insurers, Moody’s analysts said in a report sizing up challenges ahead.
By Samantha Liss • Aug. 17, 2022 -
Retrieved from National Union of Healthcare Workers on August 17, 2022
Kaiser cancels over a thousand appointments amid clinician strike
About 1,600 follow-up therapy appointments have been canceled so far this week, according to a statement from the health system.
By Hailey Mensik • Aug. 17, 2022 -
Drew Angerer via Getty Images
Payers, hospitals pleased as Biden signs sweeping health bill into law
The three-year continuation of enhanced subsidies for Affordable Care Act plans should help millions afford coverage and create some revenue stability for payers and hospitals in a tricky operational environment.
By Rebecca Pifer • Aug. 17, 2022
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