Payer: Page


  • Medicare Part B premium to drop for first time in a decade, Biden says

    The reduction is tied to lower-than-expected spending for the controversial Alzheimer’s drug Aduhelm.

    By Susan Kelly • Sept. 28, 2022
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    Nebraska awards Medicaid managed care contracts to 3 insurers

    The health plans, selected from a field of five, will receive five-year contracts.

    By Susan Kelly • Sept. 27, 2022
  • Explore the Trendline
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    Yujin Kim/Healthcare Dive
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    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
  • Moody’s downgrades Envision, citing high bankruptcy risk

    The private equity-owned physician staffing firm faces a deteriorating operating performance that could deplete its cash by the end of 2023, the rating agency warned.

    By Susan Kelly • Sept. 26, 2022
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    DOJ’s case against UnitedHealth’s Change buy was hampered by ‘serious flaws,’ judge finds

    The most serious flaws were failing to prove that UnitedHealth is likely to misuse Change Healthcare’s data to advantage the company, Judge Carl Nichols wrote.

    By Sept. 23, 2022
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    Ethan Miller / Staff via Getty Images
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    Surprise Billing

    Texas Medical Association files another lawsuit over surprise billing ban

    “We are, once again, asking for the law to be followed as Congress intended, and for the challenged provisions to be invalidated,” TMA’s president said.

    By Sept. 23, 2022
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    COVID-19 testing startup Curative pivots to health plan offering

    The plan will offer $0 copays and $0 deductibles to employers in the Austin, Texas, area after a baseline health visit is conducted.

    By Sept. 22, 2022
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    Bipartisan Senate bill aims to boost mental health access, improve worker shortages

    The legislation comes as the Biden Administration aims to tackle the country’s worsening mental health crisis, which was exacerbated by the pandemic.

    By Sept. 22, 2022
  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
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    Samantha Liss/Healthcare Dive
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    Centene to pay Texas $166M in latest state settlement

    Of the settlements made public, the insurer’s settlements so far total at least $462.7 million.

    By Sept. 21, 2022
  • Judge denies DOJ’s move to block $13B UnitedHealth, Change deal

    The judge’s ruling follows a trial in which the DOJ argued that UnitedHealth’s bid for Change would disadvantage rivals and result in higher costs, lower quality and less innovative commercial health insurance.

    By Sept. 20, 2022
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    Humana looks to buy clinics from private equity partner for up to $550M

    The insurer is accelerating the expansion of its primary care chain serving Medicare patients.

    By Susan Kelly • Sept. 19, 2022
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    Illustration: Yann Bastard for Industry Dive

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    Deep Dive

    Healthcare industry’s resiliency to surging inflation is poised to ebb

    Healthcare costs — unlike other goods and services — haven’t experienced immediate price increases amid record inflation. That’s starting to change.

    By Hailey Mensik • Sept. 15, 2022
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    AMA joins plaintiffs in class-action lawsuit against Cigna

    Jack Resneck, president of the AMA, said that the insurer is putting its “economic self-interest” ahead of physicians and patients in the Multiplan network.

    By Sept. 14, 2022
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    First Medicaid mobile mental health service to launch in Oregon

    The program supports the 988 national hotline and is part of President Joe Biden's strategy to combat the country's mental health crisis.

    By Susan Kelly • Sept. 14, 2022
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    UnitedHealthcare fires back, sues Envision for allegedly exaggerating patient claims

    The insurer filed suit in the latest legal tussle between payers and physician staffing firms.

    By Sept. 12, 2022
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    CVS enters into 4 new states for ACA exchange plans

    The insurer has been bullish on expanding its ACA footprint since 2021, when its payer business Aetna said it would return to the exchanges after exiting them in 2017.

    By Sept. 9, 2022
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    Envision sues UnitedHealthcare over allegedly denied ER claims

    Envision CEO Jim Rechtin called UnitedHealthcare’s alleged practice “cold, callous and inhumane,” according to a statement released Friday announcing a lawsuit was filed in a Tennessee federal court.

    By Sept. 9, 2022
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    Elaine Cromie/Getty Images via Getty Images
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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 Sept. 8, 2022
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    Justin Sullivan / Staff via Getty Images
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    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 Sept. 7, 2022
  • 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
  • A sign is posted in front of a Walmart store on November 16, 2021 in American Canyon, California.
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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 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 Sept. 1, 2022
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    Courtesy of Oscar Health
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    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 Aug. 31, 2022
  • Binoy Bhansali
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    Courtesy of Scan Group
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    Q&A

    Scan 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 Aug. 31, 2022
  • David Brailer, Cigna's new executive vice president and first chief health officer
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    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
  • Healthcare workers on strike hold a picket line outside a hospital.
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    Retrieved from National Union of Healthcare Workers on August 17, 2022
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    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