Payer: Page 54
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Alex Wong via Getty Images
CMS finalizes plans to hike price transparency penalties, extend telehealth flexibilities
The agency is also moving forward with a plan to stop the elimination of the Medicare inpatient-only list, which is a win for hospitals.
By Shannon Muchmore • Nov. 3, 2021 -
COVID-19 medical costs drag Aetna's commercial business, but CVS still posts $1.6B in Q3 profit
Though the pandemic continues to stress CVS' payer segment, drugstores continue to benefit from COVID-19 testing and vaccinations, particularly as a greater number of employers begin to mandate the shots.
By Rebecca Pifer • Nov. 3, 2021 -
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 -
Alex Wong via Getty Images
Outset nabs first CMS home dialysis add-on payment, setting up fight with Fresenius
The company, whose application was rejected last year, persuaded the Medicare agency its portable dialysis machine is a "substantial clinical improvement" over the incumbent home-use hemodialysis product.
By Nick Paul Taylor • Nov. 3, 2021 -
Adeline Kon/Healthcare Dive/Healthcare Dive
Deep DiveWhy are women more likely to use telehealth?
As Washington mulls over telehealth regulations post-COVID-19, it's important not to roll back access in a way that could disproportionately affect women, experts say.
By Rebecca Pifer • Nov. 2, 2021 -
Federal data shows ACA, Medicaid coverage kept uninsured rate steady as open enrollment kicks off
And the numbers suggest ACA and Medicaid enrollment may be continuing the momentum notched last year as consumers turned to the programs in droves after losing job-based coverage.
By Rebecca Pifer • Nov. 1, 2021 -
Permission granted by LaneTerralever
Sponsored by LaneTerraleverWhat elective healthcare can teach us about the future of patient experience
A new report exploring how elective procedure patients think and feel can give us insight into the changes that providers and networks must make to ensure their patients feel connected during each phase of their journey.
Nov. 1, 2021 -
Delta surge weighs on Molina's Q3 earnings, but membership up 20%
Despite pandemic pressure, the insurer largely beat Wall Street expectations, and Jefferies analysts said the company delivered "solid overall results."
By Samantha Liss • Oct. 28, 2021 -
Adeline Kon/Healthcare Dive
Deep DiveA look at Teladoc's primary care strategy from its head of US group health
In an interview, Kelly Bliss teased upcoming clients for a new virtual-first primary care product and parsed out Teladoc's growth strategies for 2022 and beyond.
By Rebecca Pifer • Oct. 27, 2021 -
Samantha Liss/Healthcare Dive
Centene looks to sell non-core assets, bounces back from Q2 loss
The insurer rebounded in the third quarter as patient utilization returned to more normal levels and revenue increased 11% year over year.
By Samantha Liss • Oct. 26, 2021 -
Julia Rendleman via Getty Images
Cigna expands telehealth benefits for employer-covered lives, including new virtual-first plan
The virtual-first plans will initially be available to large, self-insured employers, though the insurer is looking to expand to smaller sized and fully insured clients over time.
By Rebecca Pifer • Oct. 26, 2021 -
Large purchaser coalition PBGH forms new venture to lower employer health costs, starting with PBM launch
Emsana is the latest independent venture from employer interests looking to disrupt the healthcare industry, a task easier said than done.
By Rebecca Pifer • Oct. 25, 2021 -
CMMI wants every Medicare beneficiary in an accountable care plan by 2030
Officials acknowledged provider concerns that current models are too burdensome and benchmarks too complex, which the innovation center aims to fix.
By Hailey Mensik • Oct. 21, 2021 -
Anthem again hikes outlook for 2021 after Q3 medical costs beat expectations
Medical costs came in below projections despite the wave of COVID-19 hospitalizations and cases that were fueled by the delta variant during the quarter.
By Samantha Liss • Oct. 20, 2021 -
Alex Wong via Getty Images
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 -
Rebecca Pifer/Healthcare Dive
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 -
Rebecca Pifer/Healthcare Dive
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 -
Courtesy of Walmart
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 -
Spencer Platt via Getty Images
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 -
Retrieved from Abbott/PRNewswire on June 15, 2020
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 -
Alex Wong via Getty Images
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 -
Michael Nagle via Getty Images
Deep DiveHow 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 -
Mario Tama via Getty Images
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
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