Payer: Page 43
-
Getty Images
CMS targets maternal health, extends postpartum coverage
The strategy to improve outcomes and equity includes ensuring access to reproductive healthcare services and adopting a new “birthing-friendly” hospital designation.
By Susan Kelly • July 27, 2022 -
Humana to reorganize, launches executive search
The move will slim the organization down into separate units called Insurance Services and CenterWell, building on the payer’s recent acquisition of Kindred amid the push for care at home.
By Samantha Liss • July 27, 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 -
Joe Raedle via Getty Images
Elevance Health ups bet on post-acute focus
The payer, formerly known as Anthem, is leveraging its recent acquisition of myNexus to scale a new post-acute product to all of its Medicare markets, executives said last week.
By Samantha Liss • July 26, 2022 -
Samantha Liss/Healthcare Dive
Centene posts $172M loss in Q2
Despite the loss, the payer beat analyst expectations in a number of key metrics and raised its financial outlook for the remainder of the year.
By Samantha Liss • July 26, 2022 -
Getty Images
HHS proposes reinstating nondiscrimination protections stripped by Trump administration
One notable change includes language around clinical algorithms, prohibiting discrimination through the use of that technology in healthcare settings.
By Hailey Mensik • July 26, 2022 -
Permission granted by Salesforce.com
OIG warns of telehealth fraud risks in wake of DOJ crackdown
The special alert to healthcare providers describes how fraudsters recruit and reward practitioners in schemes to exploit the growth of telemedicine.
By Susan Kelly • July 25, 2022 -
Samantha Liss/Healthcare Dive
Centene to sell international assets to private hospital operator in France
The deal executes on the payer’s plan to sell off non-core assets, part of a longer-term strategy to improve profit margin.
By Samantha Liss • July 25, 2022 -
Kena Betancur via Getty Images
Elevance shares fall as medical spending metric increases
Bloomberg reported the drop was the largest intraday decline in two years for Elevance, formerly known as Anthem.
By Samantha Liss • July 21, 2022 -
Getty Images
Elevance steps away from New York Medicare Advantage contract amid continued litigation
CEO Gail Boudreaux told investors Wednesday the insurer "needed greater certainty" in order to continue with the contract.
By Samantha Liss • July 20, 2022 -
Chris Hondros via Getty Images
JPMorgan's healthcare arm to invest $30M in plan administrator Centivo
It’s Morgan Health’s third major investment in a startup looking to lower the costs of employer-sponsored healthcare in the past year.
By Rebecca Pifer • July 20, 2022 -
Brian Tucker/Healthcare Dive
SCAN Group invests in medical transportation firm in push to diversify
The deal aims to reduce the barriers seniors face in getting to healthcare appointments and builds on the group’s other recent investments.
By Samantha Liss • July 19, 2022 -
Getty Images
ACA marketplace premiums poised to jump
Health insurers' preliminary filings with state regulators point to a 10% median bump in rates for enrollees in 2023, a Kaiser Family Foundation analysis found.
By Susan Kelly • July 19, 2022 -
UnitedHealth to offer some drugs, including insulin, at no cost share in 2023
The new offering is a bid to address inflationary pressures and prevent worse health outcomes down the line, CEO Andrew Witty told investors Friday.
By Rebecca Pifer • July 15, 2022 -
Molina to pay $150M for Wisconsin Medicaid firm in latest buy
Acquisitions are key to Molina’s growth strategy, CEO Joe Zubretsky has said.
By Samantha Liss • July 14, 2022 -
Ethan Miller / Staff via Getty Images
TeamHealth sues UnitedHealthcare over denied payments for emergency services in Nevada
The lawsuit alleges that UnitedHealthcare did not pay Fremont physicians after they treated an infant with a traumatic brain injury and a child with a ruptured appendix.
By Samantha Liss • July 14, 2022 -
Getty Images
Clover to enter 13 new markets for 2023 amid rising expenses
Clover plans to offer Medicare Advantage plans in counties across Georgia, South Carolina and Tennessee next year, broadening its footprint to 220 counties in 2023.
By Rebecca Pifer • July 14, 2022 -
Getty Images
Deep Dive // Overturning of Roe v. WadeHow the spread of Catholic-owned healthcare facilities may complicate access to reproductive care
Catholic facilities must follow ethical and religious directives that say they can’t provide abortion or sterilization services and may not "promote or condone" contraceptives.
By Samantha Liss • July 13, 2022 -
Delaware awards statewide Medicaid contracts to 3 insurers
Coverage under the managed care program will begin next year.
By Samantha Liss • July 13, 2022 -
Courtesy of CVS Health
CVS names executive to new chief data, tech officer role
Tilak Mandadi will be responsible for the healthcare giant’s digital and tech strategy, along with overseeing company growth through digital and consumer-focused services.
By Rebecca Pifer • July 11, 2022 -
Getty Images
Surprise Billing1 in 5 Americans report still receiving surprise medical bills after federal ban
A Morning Consult survey highlights weakness in the surprise billing law, which does not protect consumers from balance bills related to labs and blood work in all instances.
By Samantha Liss • July 11, 2022 -
John Moore/Getty Images via Getty Images
CMS proposed payment rule includes major updates for ACOs
Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.
By Shannon Muchmore • July 8, 2022 -
Alex Wong via Getty Images
CMS finds 'troubling' implicit bias in 3 payment models
CMMI has taken initial actions to address existing bias, and has started developing a guide to screen and mitigate it in various models, according to a new article in Health Affairs.
By Rebecca Pifer • July 8, 2022 -
Photo by Liza Summer from Pexels
'Phantom' provider lists limit Medicaid mental healthcare access, study finds
The Health Affairs research showed that inaccurate provider directories may create a barrier to treatment for a population that needs it most.
By Susan Kelly • July 6, 2022 -
Joe Raedle/Getty Images via Getty Images
Marketplace insurers denied 18% of in-network claims in 2020, data shows
Five years into ACA-mandated transparency for coverage data, reporting for 2020 remained spotty, showing limited insight into coverage denials.
By Sydney Halleman • July 6, 2022 -
Social needs program for Medicaid beneficiaries can be effective but costly, research finds
The youngest patients enrolled in the program saw the greatest reduction in healthcare use while less of an impact was seen among older patients. Also, 60% of patients enrolled in the program did not engage.
By Hailey Mensik • July 5, 2022
Previous
