Divided Congress after midterms will allow HHS to execute on policy priorities, Becerra says

The department will focus on implementing drug price negotiation in Medicare and surprise billing regulations, according to the secretary.

By Rebecca Pifer Parduhn • Nov. 16, 2022

Elevance plans to continue aggressive M&A, CEO says

CEO Gail Boudreaux said the insurer plans to grow "very aggressively" into adjacent care services.

By Rebecca Pifer Parduhn • Nov. 15, 2022

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

Maven raises $90M, fueling push into Medicaid, CMO says

Roadblocks for the startup include shifting requirements state-by-state and historically low margins in Medicaid.

By Rebecca Pifer Parduhn • Nov. 15, 2022

Medical group asks Congress to offset Medicare payment cuts

The Medical Group Management Association wants Congress to take action to help physician practices by the end of the year.

By Susan Kelly • Nov. 15, 2022

Nearly 1 in 4 gig workers lacks health insurance, survey finds

A majority of those workers cited affordability as the main barrier to getting coverage, according to a poll from insurance broker Stride Health.

By Susan Kelly • Nov. 15, 2022

Cigna’s MDLive will add chronic care program to virtual primary care plans

Initially, the program will be available for patients with hypertension, but will expand throughout the year to other common chronic conditions.

By Rebecca Pifer Parduhn • Nov. 14, 2022

Bright Health ceases MA operations in Florida in latest business cut

The newest reduction for the insurtech comes less than a month after Bright announced it was leaving the Affordable Care Act exchanges and slashing its Medicare Advantage footprint to just Florida and California.

By Rebecca Pifer Parduhn • Nov. 10, 2022

Profits continue to climb for payers as possible recession looms

Despite talk of a recession, all major insurers expect a rosier end to 2022 than previously predicted. On the other hand, profits fell for large hospital operators faced with pricier labor and lower volumes.

By Samantha Liss • Nov. 9, 2022

Elevance Health to acquire specialty pharmacy BioPlus

BioPlus will complement the payer’s existing pharmacy benefit manager, IngenioRx, providing patients with specialty drugs and a whole-health approach.

By Samantha Liss • Nov. 9, 2022

What’s in it for Evernorth? Cigna’s health services arm invests $2.5B in VillageMD-Summit

The deal could have major ramifications for Evernorth’s push to value-based care in the commercial sector, according to Cigna executives and analysts.

By Rebecca Pifer Parduhn • Nov. 9, 2022

Tomorrow’s healthcare industry leaders will be masters of agility and innovation — a product mindset will show them the way

Though healthcare hasn’t always been considered a hotbed of innovation; new market pressures are pushing payer and provider organizations to become more flexible and agile than ever before.

Nov. 7, 2022

Cigna faces questions about M&A strategy amid ‘arms race’ for deals

One analyst asked whether not pursuing deals will pose a disadvantage in future years. CEO David Cordani said he is open to M&A but does not think acquisitions are a “silver bullet.”

By Samantha Liss • Nov. 3, 2022

CVS agrees to pay $5B to resolve opioid-related lawsuits

Walgreens and Walmart also have reportedly reached deals. If they become final, it could end much of the yearslong litigation over the pharmacy companies’ role in the opioid epidemic.

By Rebecca Pifer Parduhn • Nov. 2, 2022

CMS to ease Medicare ACOs into risk models in bid to boost participation

Beginning in January 2024, ACOs that don’t have experience with performance-based risk will be able to stay in a one-sided risk arrangement for up to seven years before transitioning to two-sided risk.

By Shannon Muchmore • Nov. 2, 2022

CMS finalizes requirements for rural emergency hospital designation

The conditions of participation include maintaining an average length of stay of no more than 24 hours and having emergency care available 24 hours a day, seven days a week.

By Shannon Muchmore • Nov. 2, 2022

Humana expects Medicare Advantage enrollment to grow almost 9% in 2023

Executives said better benefits are attracting more members. For certain plans, Humana members have an allowance for healthy foods, over the counter items, transportation, health supplies, rent and utilities.

By Samantha Liss • Nov. 2, 2022

Cigna partners with in-home primary care provider Heal

The provider, which focuses on care for seniors, is collaborating with Cigna to offer house calls and remote monitoring to Medicare Advantage customers in four states.

By Susan Kelly • Nov. 1, 2022

Seniors to see reduced delays in Medicare coverage under new Biden admin policies

Under the changes, traditional Medicare coverage will kick in the month immediately after enrolling.

By Samantha Liss • Oct. 31, 2022

UnitedHealthcare latest payer to expand ACA reach with 4 new states for 2023

The payer has been steadily ratcheting up its presence on the Affordable Care Act exchanges after dramatically reducing its footprint in 2017.

By Rebecca Pifer Parduhn • Oct. 28, 2022

Molina’s contract wins will have ‘profound impact’ on company, CEO says

The string of Medicaid contracts amount to $5.8 billion in additional annual premium revenue, according to CEO Joe Zubretsky.

By Samantha Liss • Oct. 27, 2022

Express Scripts lands its largest client in Centene

Cigna’s Express Scripts will manage more than $35 billion in annual prescription drug spend for Centene, which will soon be its No. 1 client.

By Samantha Liss • Oct. 26, 2022

Nearly half of consumers are in debt due to medical bills, survey finds

Many are struggling to afford their private health insurance and are unprepared for a medical emergency, a poll conducted for telehealth provider Babylon showed.

By Susan Kelly • Oct. 26, 2022

10-week Kaiser strike ends with deal aimed at improving mental health access

About 2,000 mental health clinicians at the system’s facilities in Northern California walked off the job in protest of what they said were prolonged wait times and unmanageable work loads.

By Hailey Mensik • Oct. 25, 2022

Cigna’s Express Scripts wins Centene’s $35B prescription drug contract

The PBM contract is one of the largest to change hands recently, one analyst said. Centene will drop CVS Caremark in 2024.

By Samantha Liss • Oct. 25, 2022

Leveraging AI to benefit the healthcare ecosystem for providers, payers and members

Research revealed leveraging AI will benefit the entire healthcare ecosystem for payers.  

By Bevey Miner, HIT Strategist, Consensus Cloud Solutions • Oct. 24, 2022