CVS Health's Aetna unveils nationwide primary care telehealth service

The vertically integrated healthcare giant is working with Teladoc to offer the program, which combines telehealth services and access to in-person visits with providers in the CVS Health-Aetna network.

By Susan Kelly • Aug. 11, 2021

Delaware caps hospital price growth to fund more primary care

Gov. John Carney signed the multi-pronged healthcare bill on Friday. "As I think about the things, particularly in healthcare that we focus on, there's not much that's more important than this," he said.

By Samantha Liss • Updated Oct. 5, 2021

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

Putting a stop to unjustified high drug prices

Find out how CVS Caremark is protecting payors and patients from overpriced medications

Aug. 9, 2021

Utilization bounced back for payers in Q2, dinging profitability

Patient volumes returned and drove net income down significantly year over year for insurers, which posted record profits during the same time last year when medical care was largely put off.

By Hailey Mensik • Aug. 6, 2021

Evernorth drives Cigna's Q2 revenue growth despite more return to care than expected

Executives said Thursday that COVID-19-related costs were also higher than anticipated for the quarter.  

By Shannon Muchmore • Aug. 5, 2021

OIG audit targets Aetna’s Medicare Advantage plans as government cracks down on fraud

CVS contends the reviews are a regular part of doing business in federal programs, and it "expects CMS and the OIG to continue these types of audits."

By Rebecca Pifer • Aug. 5, 2021

After controversial approval, doctors are still debating how to use Biogen's Alzheimer's drug

Nearly two months since Aduhelm became available, many physicians have yet to use the first treatment approved in the U.S. to slow Alzheimer's disease.

By Jacob Bell • Updated Aug. 3, 2021

CVS profit dips to $2.8B as patients return, COVID-19 costs persist

Lagging vaccination rates lead the company to expect the pandemic to be a "modest negative for 2021," CFO Shawn Guertin said. Previously, it expected COVID-19 to have little to no impact on full-year earnings.

By Rebecca Pifer • Aug. 4, 2021

Boston Scientific, Stryker get extra year of add-on payments as CMS adjusts to pandemic

Comments "overwhelmingly supported" the plan to use pre-pandemic data on the cost of inpatient stays to inform CMS' rates for fiscal 2022.

By Nick Paul Taylor • Aug. 3, 2021

CMS axes hospital price transparency mandate from 2022 inpatient payment rule

Hospitals will also receive a 2.5% pay bump for inpatient stays in 2022 under the new rule. That's lower than the 2.8% proposed in the initial draft, but "largely within the range of market expectations," one analyst wrote.

By Rebecca Pifer • Aug. 3, 2021

Molina sees bump in coronavirus inpatient costs as delta variant takes hold

Those COVID-19 costs quickly tapered off as the quarter progressed, executives said. Still, the insurer was able to post a second quarter profit as more members sought care. 

By Samantha Liss • July 29, 2021

How the pandemic has accelerated digital payments in telehealth

Digitalization can simplify the medical bill payment process and give patients more information earlier on about their financial responsibilities, experts said.

By J. Duncan Moore, Jr. • July 28, 2021

Humana warns of 'uncertainty' in medical usage amid rising COVID-19 cases

Medical utilization bounced back faster than the payer expected, though the company was still able to post a profit for the second quarter.

By Samantha Liss • July 28, 2021

'Pent up demand' spurs Centene Q2 net loss as more members seek care

Executives warned, however, that the delta variant is raging. "It remains clear that the pandemic is not over, and the environment could remain choppy for the balance of the year," CEO Michael Neidorff said.

By Samantha Liss • July 27, 2021

Anthem again ups 2021 expectations amid robust membership growth, contract wins

"We have also taken a slightly more cautious view of the back half of the year, in light of new COVID variants, coupled with a slowing vaccination rate," CFO John Gallina said Wednesday.

By Samantha Liss • July 21, 2021

Medical debt overtakes nonmedical as largest source in collections. COVID-19 may be making it worse.

The study published in JAMA also found medical debt was significantly more concentrated in states that didn't expand Medicaid under the Affordable Care Act.

By Rebecca Pifer • July 21, 2021

Radiation therapy 'under attack' from CMS cuts, professional body warns

Equipment manufacturers including Varian, ViewRay, Hitachi, Siemens and Elekta could be affected by the reimbursement changes.

By Nick Paul Taylor • July 21, 2021

Large self-insured employers lack power in hospital price negotiations

A study in The American Journal of Managed care found that hospital market power far outweighs employer market power, suggesting employers may want to consider forging purchase alliances with local government employee groups.

By Samantha Liss • July 16, 2021

UnitedHealth brings in $71B in revenue, biding time on Biogen Alzheimer's drug coverage call

The health giant also expects both utilization and service acuity to trend up progressively in the back half of 2021. ​"We haven't observed that yet, but it's probably too early to say," CFO John Rex told investors Thursday.

By Rebecca Pifer • July 15, 2021

CMS proposes extension of Medicare telehealth coverage

Provider groups are not happy with the payment adjustment in the rule — a 3.75% reduction to the conversion factor due to budget neutrality requirements — and will likely seek congressional intervention.

By Shannon Muchmore • July 14, 2021

MDUFA talks expose 'fundamentally different' views of FDA and device companies

At the latest meeting over user fees, industry remained opposed to the agency's pitch for a Total Product Life Cycle Advisory Program, which it contends would extend the scope beyond FDA's purview. 

By Nick Paul Taylor • July 14, 2021

FDA revises labeling of Biogen Alzheimer's drug to emphasize early treatment

The drug's already controversial OK was made more so for applying to an exceptionally broad patient group. Critics argued the original label would spur use in those unlikely to benefit and balloon Medicare spending.

By Ned Pagliarulo , Ben Fidler • July 8, 2021

Dexcom CEO on the Type 2 population, the Super Bowl ad and pandemic momentum

Kevin Sayer called Type 2 diabetes a "tremendous market opportunity" and said direct-to-consumer advertising is worth some controversy.

By Ricky Zipp • July 6, 2021

CMS unveils new ESRD payment model in health equity push

The tweaks to the end-stage renal disease model is the CMS innovation center's first direct effort to address health disparities, a key priority for the Biden administration.

By Rebecca Pifer • July 2, 2021

First of surprise billing ban rules mum on arbitration details

The highly anticipated rule bans surprise out-of-network and balance billing beginning in 2022 for people in employer-sponsored or individual marketplace plans.

By Rebecca Pifer • July 1, 2021