Payer: Page 57
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Molina membership growth propelled revenue, profit in Q1
The insurer is poised to see additional gains throughout the year as the special enrollment period for Healthcare.gov remains open and states are barred from removing Medicaid members from their rolls.
By Samantha Liss • April 29, 2021 -
Humana snaps up remaining stake in home health giant Kindred for $5.7B
The payer also reported first quarter revenue of $20.7 billion on profit of $828 million, up a whopping 75% year over year.
By Rebecca Pifer • April 28, 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 -
CMS pitches extra year of add-on payments for Boston Scientific, Stryker, other devices
In light of the COVID-19 pandemic, the agency is proposing the payments to hospitals be extended beyond the typical timeframe for 14 products.
By Nick Paul Taylor • April 28, 2021 -
Retrieved from Paul Sableman on March 12, 2021
Centene Q1 performance fueled by lower medical usage, 1.3M new members
Executives seemed optimistic about the remainder of the year, raising full-year guidance as they see momentum coming from Medicaid and Affordable Care Act marketplace growth due to the special enrollment period.
By Samantha Liss • April 27, 2021 -
Molina acquires Cigna's Medicaid business in Texas for $60M
The deal is set to boost Molina's existing footprint in the state as the managed care company continues to execute on its strategy of growth through bolt-on acquisitions.
By Samantha Liss • April 23, 2021 -
Drew Angerer via Getty Images
ACA navigator funds get massive boost to record level
The agency also said about 12 million people enrolled in an Affordable Care Act plan during the 2021 open enrollment period, a 5% increase from the year prior.
By Shannon Muchmore • April 22, 2021 -
Thomas Barwick via Getty Images
AdvaMed pushes CMS to implement MCIT final rule without further delay
The Medicare agency postponed the proposal from taking effect amid criticism from some doctors and safety groups that it risks promoting device use without rigorous evidence of safety and effectiveness.
By Susan Kelly • April 21, 2021 -
Getty / Edited by BioPharma Dive
Bluebird to withdraw gene therapy from Germany after dispute over price
The biotech will cut staff, primarily in Europe, after negotiations with German health authorities resulted in a price lower than Bluebird had sought.
By Ned Pagliarulo • April 21, 2021 -
Anthem reports major Medicaid growth in Q1 as executives downplay concerns of pent-up care demands
The payer reported a profit for the quarter driven by performance of its pharmacy benefit management arm and its government plans. It missed Street expectations on revenue, but beat on earnings and hiked EPS guidance.
By Shannon Muchmore • April 21, 2021 -
Adeline Kon/Healthcare Dive/Healthcare Dive
What to watch as health systems and insurers report Q1 results
For both payers and providers, volumes will be an important metric. The lingering question is how quickly patients will return to in-person care.
By Samantha Liss , Shannon Muchmore • April 20, 2021 -
Alex Wong via Getty Images
Value-based care at 'critical juncture,' new CMMI chief says
Even though some testing payment models have been delayed or discarded, CMMI's new leader said the agency remains committed to finding models that reward value not volume.
By Rebecca Pifer • April 20, 2021 -
Courtesy of Humana
Humana nets nearly $200M in overpayments, OIG audit finds
The watchdog said the payer submitted documentation that inaccurately showed some of its Medicare Advantage members were sicker than they actually were.
By Samantha Liss • April 20, 2021 -
UnitedHealth kicks off Q1 earnings season with 44% profit jump
Care was still muted in the first quarter even as vaccinations ramped up and states lifted restrictions, contributing to the healthcare behemoth's $4.9 billion bottom line.
By Rebecca Pifer • April 15, 2021 -
Anthem, Blackstone, digital health startup K Health launch joint venture to curb costs
Financial terms of the deal were not disclosed, but the new venture, which has been in the works for years, will use AI tools in an attempt to better triage patient care.
By Rebecca Pifer • April 14, 2021 -
Doubts cast on CPAP efficacy evidence in HHS agency review
A report prepared for the Agency for Healthcare Research and Quality found available studies "mostly" do not support a link between continuous positive airway pressure therapy and long-term, clinically important outcomes.
By Nick Paul Taylor • April 14, 2021 -
Surprise Billing
Patients hit with surprise medical bills paid ER docs 10 times more than others
The findings published in Health Affairs suggest why some ER groups resist coming in-network with insurers: They stand to collect more in revenue if they stay outside a network, posing a financial risk to patients.
By Samantha Liss • April 13, 2021 -
Kaiser Permanente taps chief information technology officer
Diane Comer, who joined the integrated system in 2007, helped deploy the tech systems needed to support the Affordable Care Act and health insurance exchanges.
By Roberto Torres • April 9, 2021 -
Urgent care centers draw some ER visits but associated with higher spending overall
The findings published in Health Affairs may suggest patients are going to the centers instead of more appropriate and lower cost settings like a primary care office or virtual visit.
By Shannon Muchmore • April 7, 2021 -
Brian Thompson named CEO of UnitedHealthcare
The executive, who joined UnitedHealth Group in 2004, was most recently head of UnitedHealthcare's government business, including its Medicare, retirement and community and state divisions.
By Rebecca Pifer • April 7, 2021 -
Medtechs top pharma in cash to doctors for consulting, travel: Health Affairs
The study also found payments from medical device companies increased greatly as Medicare billing increased among surgeons.
By Ricky Zipp • April 7, 2021 -
Medtronic inks value-based care pact with Spectrum Health
The risk-based deal, initially focused on cardiac resynchronization therapy, will have the medtech giant paying the provider if certain patient metrics are not met, according to a spokesperson for the health system.
By Nick Paul Taylor • April 1, 2021 -
One-third of small businesses say health insurance is a top concern during COVID-19: survey
The new poll from the Small Business Majority and Families USA also found that pain is particularly acute among Black-, Asian American- and Latino-owned businesses, which tend to have fewer resources than their White counterparts.
By Rebecca Pifer • March 31, 2021 -
Payer lobbies cheer new bipartisan bill allowing audio-only telehealth in MA
"Lawmakers have recognized the importance of telehealth, and this important legislation recognizes that for many seniors, a phone call is their only option for health care at home," AHIP CEO Matt Eyles said Wednesday.
By Rebecca Pifer • March 25, 2021 -
Reality check: Amazon Care may not be that big of a deal
Currently, the effort is a more direct threat to employer-facing point solutions, instead of the more comprehensive offerings from entrenched vendors.
By Rebecca Pifer • March 23, 2021 -
Courtesy of Humana
Humana CFO to depart
Susan Diamond, president of the health insurer's home business, will assume the role of interim CFO on June 1 while Humana completes an external search for Brian Kane's replacement.
By Jane Thier • March 23, 2021
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