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 -
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➔
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 -
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 -
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 Samantha Liss • Sept. 23, 2022 -
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 Shannon Muchmore • Sept. 23, 2022 -
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 Shannon Muchmore • Sept. 22, 2022 -
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 Sydney Halleman • Sept. 22, 2022 -
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 Samantha Liss • 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 Samantha Liss • Sept. 20, 2022 -
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 -
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 -
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 Sydney Halleman • Sept. 14, 2022 -
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 -
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 Samantha Liss • Sept. 12, 2022 -
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 Rebecca Pifer Parduhn • Sept. 9, 2022 -
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 Samantha Liss • Sept. 9, 2022 -
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 Sydney Halleman • Sept. 8, 2022 -
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 Samantha Liss • 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 -
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 Rebecca Pifer Parduhn • Sept. 7, 2022 -
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 Rebecca Pifer Parduhn • Sept. 1, 2022 -
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 Rebecca Pifer Parduhn • Aug. 31, 2022 -
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 Samantha Liss • Aug. 31, 2022 -
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 -
Retrieved from National Union of Healthcare Workers on August 17, 2022
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