In last ditch plea to save MCIT, medtech groups suggest fixes to CMS

AdvaMed and MDMA responded to a call for feedback on the planned repeal of the Medicare Coverage of Innovative Technology pathway by proposing tweaks and new ideas to salvage it.

By Nick Paul Taylor • Oct. 20, 2021

UnitedHealthcare to launch virtual-first primary care plan by end of year, COO says

The company is seeking to capitalize on the preference for home-based and telehealth care, a trend that took off during the pandemic.

By Rebecca Pifer • Oct. 19, 2021

Explore the Trendline➔

Payer/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

Amazon teases 5 more cities to get virtual Amazon Care offering this year

Amazon Care is currently live in the Washington, D.C. and Baltimore area, and will be rolled out in Dallas, Chicago, Philadelphia, Boston and Los Angeles this year, the unit's director told the HLTH conference Tuesday.

By Rebecca Pifer • Oct. 19, 2021

Walmart, Transcarent partner to pitch self-insured employers

The retail giant will make its low-cost prescription drugs, along with its optical, telehealth and other services available to self-insured employers while leveraging Transcarent’s digital platform.

By Hailey Mensik • Oct. 18, 2021

What to expect from payer, provider Q3 earnings

The intense volume of COVID-19 patients that came from the delta surge will likely influence winners and losers for the third quarter. Results ramp up this week.

By Samantha Liss • Oct. 18, 2021

UnitedHealth, with profit up 29%, expects contested Change acquisition to close early 2022

The closing news is likely to anger hospital groups, which have raised concerns the deal could hurt health IT competition and give the payer an unfair advantage in contract negotiations. DOJ is investigating the deal.

By Rebecca Pifer • Oct. 14, 2021

Abbott, Dexcom could benefit from CGM use jump among Type 2 diabetes patients: report

The population could drive the next wave of demand for devices to track and control diabetes, Jefferies analysts predicted, following a recent CMS coverage change that rolled back restrictions to CGM access.

By Susan Kelly • Oct. 13, 2021

Medicare Advantage, Part D plans with 4 or more stars soaring, CMS says

About 90% of people currently enrolled in MA plans offering prescription drug coverage are enrolled in a plan that will earn four stars in 2022.

By Hailey Mensik • Oct. 11, 2021

Molina to buy AgeWell's long-term care business in New York for $110M

As part of the deal, Molina will pick up about 13,000 people covered by AgeWell's long-term care services. In 2020, the premium revenue generated from these members was about $700 million.

By Samantha Liss • Oct. 8, 2021

Feds OK health plan discounts for coronavirus vaccination

Such rewards must meet certain requirements, however, including a rule that they not exceed 30% of the cost of employee-only coverage.

By Kate Tornone • Oct. 7, 2021

How Morgan Health hopes to finally move the needle on employer health costs: 5 insights from a chat with the venture's CEO

Morgan Health learned a lot from Haven, but is a different beast with better knowledge of the buy-in needed to disrupt the health benefits space, CEO Dan Mendelson told Healthcare Dive.

By Rebecca Pifer • Oct. 7, 2021

Air ambulance charges zoom upward for commercial insurers, but not Medicare

Allowed in-network charges for fixed-wing air ambulances rose 76.4% between 2017 and 2020, and now top $15,000, a new study by Fair Health found.

By Ron Shinkman • Oct. 4, 2021

FDA's real-world evidence push hampered by data challenges, 'million-dollar question'

While the agency wants to tap information like electronic health records and wearables to make pre- and postmarket decisions, these sources do not have the same quality controls as clinical trials. 

By Greg Slabodkin • Oct. 4, 2021

MA premiums will dip as payers expand footprints

Cigna, UnitedHealth and Centene are all entering new areas for 2022, but analysts say benefit options show that bids from insurers are relatively conservative.

By Shannon Muchmore • Updated Oct. 5, 2021

Centene reaches $72M settlement with Illinois, Arkansas for alleged Medicaid overcharges

The two states allege Centene failed to disclose relevant discounts and inflated dispensing fees. The latest settlements come months after similar agreements were reached in Ohio and Mississippi.

By Samantha Liss • Oct. 1, 2021

Doctors slam surprise billing rule that details dispute resolution process

The interim final rule established that existing rates in a provider's geographic area will be a strong anchor for final payment decisions by arbitrators.

By Shannon Muchmore • Oct. 1, 2021

Consumer satisfaction with telehealth fell from last year, J.D. Power finds

Among direct-to-consumer brands, Teladoc ranked highest for consumer satisfaction, followed by MDLive. Among payer-sponsored services, UnitedHealthcare ranked the highest.

By Hailey Mensik • Sept. 30, 2021

AMA calls out shrinking payer competition amid rising antitrust interest in Washington

The study by the physician group is the latest salvo in a messaging war between provider and payer lobbies as they work to shift the blame for rapidly rising medical costs.

By Rebecca Pifer • Sept. 29, 2021

CMS defends proposal to nix MCIT pathway, but medtechs hold out hope

If the bid to repeal the breakthrough payment rule is finalized, the agency's CMO committed to an alternative pathway that evaluates devices for Medicare patients potentially via clinical trials, outcome registries and real-world data.

By Greg Slabodkin • Sept. 29, 2021

Free insurance under COBRA for Americans without job-based coverage ends Thursday

Experts say there was huge demand for the six-month subsidy, with one estimate finding more than 16 million people lost their employer-sponsored health insurance during the pandemic.

By Rebecca Pifer • Sept. 29, 2021

Broadband investments can improve health, as long as insurers don't roll back telehealth coverage

Jason Resendez of Consumers for Quality Care argues it's time for insurers, policymakers and health systems to embrace telehealth as an integral part of the future of healthcare.

By Jason Resendez • Sept. 27, 2021

Healthcare 2025: Health plans look ahead to emerging business opportunities

Eager to learn how health plans view their role and other stakeholders in the overall healthcare ecosystem today?

Sept. 27, 2021

Centene, Humana sue Merck for 'monopolistic scheme' to delay generics of blockbuster cholesterol drug

The suits allege an agreement between Merck and a generic manufacturer kept lower-cost versions of the drugmaker's widely used pill Zetia off the market for years. 

By Samantha Liss • Sept. 24, 2021

State Medicaid officials face daunting fall season amid low vaccination rates, record enrollment

Telehealth and behavioral health service needs are also a challenge as the COVID-19 pandemic drags on and the Biden administration encourages more people to get on the rolls.

By Hailey Mensik • Sept. 23, 2021

Cigna expands purview of global CIO

Noelle Eder, who first joined the company in August 2020, will add data and analytics to her role.

By Roberto Torres • Sept. 23, 2021