Biden administration makes record-high investment in ACA navigators

The administration is pouring almost $100 million into organizations that help consumers navigate enrolling in Affordable Care Act plans in 2023.

By Rebecca Pifer Parduhn • Aug. 29, 2022

Cigna expanding ACA footprint to 3 new states in 2023

The expansion comes a little over a week since President Joe Biden signed a law extending subsidies for coverage and subsequently creating more stability in the exchanges.

By Rebecca Pifer Parduhn • Aug. 29, 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

Congress finally eliminates Part D vaccine cost sharing: Medicare coverage is still broken

The Inflation Reduction Act leaves intact a peculiar split in Medicare vaccine coverage that discourages physicians from offering certain vaccines, argues former Moderna Vice President Richard Hughes.

By Richard Hughes • Aug. 26, 2022

Molina, Elevance, Centene win big with Medicaid contracts in California

The managed care organizations already held Medicaid contracts with the state, but the overhaul in counties served is causing one payer to consider appealing the proposed contracts.

By Rebecca Pifer Parduhn • Updated Aug. 29, 2022

Healthcare cost growth trails overall price hikes amid record inflation

Prices in the U.S. economy grew 8.5% in July compared to last year, while prices for medical care increased just 4.8%, according to a tracker from the Kaiser Family Foundation and Peterson Center on Healthcare.

By Hailey Mensik • Aug. 25, 2022

Judge blocks part of Idaho law, allowing physicians to perform abortions in emergencies

The ruling sides with the Biden administration, delivering a partial win for the DOJ in its first legal challenge since the Supreme Court ruled to overturn the constitutional right to an abortion.

By Samantha Liss • Aug. 25, 2022

Medicare Advantage lobby rebuts senator’s inquiry into ‘potentially deceptive’ marketing tactics

The Better Medicare Alliance is arguing that marketing materials for MA plans are already subject to “careful regulation” and adhere to a 53-page set of federal guidelines.

By Rebecca Pifer Parduhn • Aug. 24, 2022

4 California healthcare organizations reach $71M False Claims settlement

The organizations allegedly pocketed Medicaid adult expansion program funds meant to be returned to the state, according to a DOJ release.

By Hailey Mensik • Aug. 23, 2022

15M Medicaid enrollees risk coverage loss when COVID-19 health emergency ends, HHS reports

A disproportionate number of those who stand to lose coverage are children and young adults, according to the agency.

By Susan Kelly • Aug. 23, 2022

Federal regulators nix contested language in surprise billing final rule

The final rule removes the earlier requirement that arbiters must first presume that the median in-network rate is the appropriate payment. 

By Samantha Liss • Aug. 22, 2022

CMS aims to mandate state quality reporting for Medicaid, CHIP

The proposed rule would require states to report on quality measurements for the two growing programs for the first time.

By Susan Kelly • Aug. 22, 2022

Employer health costs expected to rise 6.5% next year, report finds

The rise is predicted to outpace the prior increase of 3.7% growth in employer costs between 2021 and 2022. Though it is expected to remain below the Consumer Price Index, a figure reflecting inflation.

By Hailey Mensik • Aug. 18, 2022

The promise of payer transparency

A new price transparency rule lends itself to creating a more equitable, cost-effective market for medical coverage, Clarify Health chief analytics and privacy officer Niall Brennan argues.

By Niall Brennan • Aug. 17, 2022

Slowing economy could ding insurers, Moody’s says

A slowdown in the economy may result in job losses and clip commercial enrollment, which would push down a key earnings driver for insurers, Moody’s analysts said in a report sizing up challenges ahead.

By Samantha Liss • Aug. 17, 2022

Kaiser cancels over a thousand appointments amid clinician strike

About 1,600 follow-up therapy appointments have been canceled so far this week, according to a statement from the health system.

By Hailey Mensik • Aug. 17, 2022

Payers, hospitals pleased as Biden signs sweeping health bill into law

The three-year continuation of enhanced subsidies for Affordable Care Act plans should help millions afford coverage and create some revenue stability for payers and hospitals in a tricky operational environment.

By Rebecca Pifer Parduhn • Aug. 17, 2022

FTC tells states to avoid shielding hospital mergers from antitrust enforcement

A report released Monday compiles research that shows arrangements, called Certificates of Public Advantage, result in higher prices, lower quality of care and lower wage growth for employees.

By Samantha Liss • Aug. 16, 2022

Cigna, Oscar to offer small business plans in Philadelphia

Insurtech Oscar is pushing further into the small employer market through its partnership with Cigna while it holds off on adding more full-service agreements.

By Susan Kelly • Aug. 16, 2022

Humana inks deal to expand in Medicaid managed care

The payer acquired Wisconsin-based Inclusa on the heels of its $2.8 billion divestiture of Kindred at Home's hospice and personal care units.

By Susan Kelly • Aug. 15, 2022

Cardinal Health CFO will replace CEO Mike Kaufmann

Jason Hollar, who joined Cardinal as CFO in 2020, will lead the healthcare distributor starting in September.

By Samantha Liss • Aug. 15, 2022

House passes bill extending ACA subsidies, allowing Medicare drug price negotiations

The bill, which passed on party lines in a 220-207 vote, will now head to President Joe Biden’s desk. He is expected to sign it into law this week.

By Sydney Halleman • Aug. 15, 2022

Oscar Health pauses full-service tech deals amid implementation woes

The decision to halt new technology agreements doesn’t change Oscar’s financial expectations for 2022, as the insurtech plans to reallocate resources to focus on achieving profitability in its insurance operations next year.

By Rebecca Pifer Parduhn • Aug. 12, 2022

New York judge dismisses surgeon’s lawsuit challenging surprise billing law

The lawsuit threatened to again expose millions of patients to surprise out-of-network bills.

By Samantha Liss • Aug. 11, 2022

Scan Health Plan makes push into Texas

The Medicare Advantage insurer will cover seniors in a total of four states, pending regulatory approval.

By Samantha Liss • Aug. 10, 2022

Profits climb for major insurers as hospital volumes drop in Q2

All but two of the seven largest insurers saw profits climb in the second quarter as hospital operators continued to struggle with weak volumes and higher labor costs amid record-high inflation.

By Samantha Liss • Aug. 9, 2022