Payer: Page 56
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Medicaid insurers at heart of Nevada public option plan
The state will bid out the business to private insurance carriers instead of doing the work in-house. Medicaid managed care organizations Centene, UnitedHealthcare and Anthem will be required to submit a bid.
By Samantha Liss • June 2, 2021 -
EQRx readies a lower-cost alternative to pricey cancer immunotherapies
The biotech and its partner CStone disclosed Phase 3 results in lung cancer that support approval plans for a drug similar to treatments like Merck's Keytruda, but would be priced at a fraction of the cost.
By Ben Fidler • June 2, 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 -
ACLA appeals dismissal of PAMA lawsuit, pushes legislative fixes
The lab trade group for Quest, LabCorp and others argues the Protecting Access to Medicare Act is a case of "harmful regulatory overreach" that forces an "unsustainable reimbursement model" on its members.
By Nick Paul Taylor • June 2, 2021 -
Privately insured face worse access, higher costs than those in public plans: JAMA report
The new research comes roughly a week after Democrats revived efforts to draft legislation enacting a Medicare-like public option, a bid to reduce the nation's uninsured rate and lower healthcare costs.
By Rebecca Pifer • June 1, 2021 -
Retrieved from National Cancer Institute on September 27, 2019
In first, FDA approves KRAS-blocking cancer drug from Amgen
Lumakras is the first drug proven effective in targeting the KRAS gene, which is often mutated in lung, colon and pancreatic cancers. Amgen will charge $17,900 per month for Lumakras at list price, which doesn't account for rebates or discounts that may be offered to insurers.
By Ned Pagliarulo • June 1, 2021 -
Geber86 via Getty Images
Family healthcare costs decreased last year for first time in Milliman report's 16-year history
However, the trend is not expected to continue into 2021. Costs are predicted to jump nearly 9% to $28,256 next year for a family of four.
By Samantha Liss • May 28, 2021 -
Senate confirms Chiquita Brooks-LaSure as head of CMS
Industry groups cheered her confirmation, saying Brooks-LaSure's policy know-how and experience managing insurance programs should help increase equitable access to affordable care in the U.S.
By Rebecca Pifer • May 25, 2021 -
ICER, vocal critic of drug company pricing, turns scrutiny to insurers
The watchdog group plans to examine how cost sharing can hurt access to care, but it won't assess some of the most controversial insurer practices.
By Jonathan Gardner • May 25, 2021 -
Anthem wrongly received $3.4M in MA overpayments, OIG says
The insurer is the latest to face allegations of receiving Medicare Advantage overpayments tied to patients who were inaccurately identified as part of a high-risk group.
By Samantha Liss • May 25, 2021 -
Chris Hondros via Getty Images
After Haven flop, JPMorgan Chase unveils solo healthcare venture
Morgan Health, somewhat of a successor to the defunct collaboration with Amazon and Berkshire Hathaway, comes armed with $250 million to invest in innovations in employer coverage and advancements in health equity.
By Dan Ennis , Rebecca Pifer • May 21, 2021 -
Anthem, Epic launch data-sharing partnership
The collaboration will integrate Epic's payer platform into Anthem's operating system, in a bid to streamline administrative processes like electronic prior authorization while harnessing more real-time data on patient behaviors.
By Shannon Muchmore , Rebecca Pifer • May 20, 2021 -
[Photograph]. Retrieved from Regional Health Command Atlantic.
More than 1 in 4 Medicare beneficiaries used telehealth between summer and fall last year
A Kaiser Family Foundation report also found a majority of beneficiaries using virtual care accessed it over the phone, hinting at continued demand for audio-only telehealth beyond the COVID-19 public health emergency.
By Rebecca Pifer • May 20, 2021 -
Courtesy of Exact Sciences
US panel trims colorectal cancer screening age, broadening payer mandate
The action means private insurers have to cover the screening of adults aged 45 to 49 years under the Affordable Care Act.
By Nick Paul Taylor • May 19, 2021 -
Bruce Bennett via Getty Images
Former Aetna exec becomes CVS CFO
Incoming finance chief Shawn Guertin was originally expected to take the job after the retail behemoth's 2018 acquisition of Aetna, but initially declined, citing personal and family reasons.
By Jane Thier • May 18, 2021 -
Kena Betancur via Getty Images
Clover net loss balloons due to higher-than-expected medical costs
An ongoing SEC probe could pose a significant risk to the payer, which gets most of its revenue from government programs.
By Rebecca Pifer • May 18, 2021 -
FatCamera via Getty Images
Sponsored by ZSLife sciences' role in achieving health equity
How can we mend the industry's foundation? And, what role can life sciences companies play in healthcare's quest to improve healthcare for all?
By Nan Gu and Harshil Gagnani • May 17, 2021 -
Alex Wong via Getty Images
CMS again delays breakthrough device payment rule in nod to skeptics
Medtech manufacturers pushed for the MCIT rule, but high-profile detractors like payer lobby America's Health Insurance Plans and doctor groups drove CMS to delay implementation, citing potential risks to Medicare beneficiaries.
By Nick Paul Taylor • May 17, 2021 -
Almost all major US payers hiked forecasts following Q1, hinting at 2021 optimism despite COVID-19
Humana was the only major insurer not to increase its full-year earnings outlook following a strong quarterly showing in the benefits sector.
May 12, 2021 -
Cigna signals optimism for 2021 as it raises forecasts despite ongoing pandemic
The insurer bested Wall Street expectations in the first quarter with $1.2 billion in profit on $41 billion in revenue.
By Samantha Liss • May 7, 2021 -
Drew Angerer via Getty Images
ACA special enrollment period sign-ups surged in April
The Biden administration began the SEP primarily to help people who have lost coverage due to the COVID-19 pandemic and related economic fallout.
By Shannon Muchmore • May 7, 2021 -
Courtesy of Amwell
Cigna adds in-network virtual mental healthcare, highlighting focus on treatment access
Ginger provides Cigna customers with behavioral health coaching, therapy and psychiatry services through its app.
By Katie Clarey • May 5, 2021 -
Bruce Bennett via Getty Images
CVS profit up 10%, but warns vaccine hesitancy could dampen earnings
The diversified health behemoth beat Wall Street quarterly forecasts with revenue of $69.1 billion, raising its full-year guidance as a result.
By Rebecca Pifer • May 4, 2021 -
COVID-19 spurred growing profitability in insurance markets last year, KFF says
Still, the Kaiser Family Foundation report stressed the pandemic's long-term financial ramifications on insurers are uncertain, as a bounceback in utilization and shifting regulatory requirements could dampen future income.
By Rebecca Pifer • May 3, 2021 -
sturti via Getty Images
Sponsored by Pulse8Using risk adjustment analytics to precision target interventions
Dynamic intervention planning helps payers save time and money while reducing 20-30% interventions.
By Scott Stratton, MPH • May 3, 2021 -
Kentucky must rebid Medicaid contracts again, judge rules
This ruling puts six insurers at risk of losing their lucrative contracts with the state. It's unclear when the state will rebid the work.
By Samantha Liss • April 30, 2021
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