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JPMorgan's healthcare arm to invest $30M in plan administrator Centivo
It’s Morgan Health’s third major investment in a startup looking to lower the costs of employer-sponsored healthcare in the past year.
By Rebecca Pifer Parduhn • July 20, 2022 -
Brian Tucker/Healthcare Dive
SCAN Group invests in medical transportation firm in push to diversify
The deal aims to reduce the barriers seniors face in getting to healthcare appointments and builds on the group’s other recent investments.
By Samantha Liss • July 19, 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 -
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ACA marketplace premiums poised to jump
Health insurers' preliminary filings with state regulators point to a 10% median bump in rates for enrollees in 2023, a Kaiser Family Foundation analysis found.
By Susan Kelly • July 19, 2022 -
UnitedHealth to offer some drugs, including insulin, at no cost share in 2023
The new offering is a bid to address inflationary pressures and prevent worse health outcomes down the line, CEO Andrew Witty told investors Friday.
By Rebecca Pifer Parduhn • July 15, 2022 -
Molina to pay $150M for Wisconsin Medicaid firm in latest buy
Acquisitions are key to Molina’s growth strategy, CEO Joe Zubretsky has said.
By Samantha Liss • July 14, 2022 -
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TeamHealth sues UnitedHealthcare over denied payments for emergency services in Nevada
The lawsuit alleges that UnitedHealthcare did not pay Fremont physicians after they treated an infant with a traumatic brain injury and a child with a ruptured appendix.
By Samantha Liss • July 14, 2022 -
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Clover to enter 13 new markets for 2023 amid rising expenses
Clover plans to offer Medicare Advantage plans in counties across Georgia, South Carolina and Tennessee next year, broadening its footprint to 220 counties in 2023.
By Rebecca Pifer Parduhn • July 14, 2022 -
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Deep Dive // Overturning of Roe v. WadeHow the spread of Catholic-owned healthcare facilities may complicate access to reproductive care
Catholic facilities must follow ethical and religious directives that say they can’t provide abortion or sterilization services and may not "promote or condone" contraceptives.
By Samantha Liss • July 13, 2022 -
Delaware awards statewide Medicaid contracts to 3 insurers
Coverage under the managed care program will begin next year.
By Samantha Liss • July 13, 2022 -
Courtesy of CVS Health
CVS names executive to new chief data, tech officer role
Tilak Mandadi will be responsible for the healthcare giant’s digital and tech strategy, along with overseeing company growth through digital and consumer-focused services.
By Rebecca Pifer Parduhn • July 11, 2022 -
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Surprise Billing1 in 5 Americans report still receiving surprise medical bills after federal ban
A Morning Consult survey highlights weakness in the surprise billing law, which does not protect consumers from balance bills related to labs and blood work in all instances.
By Samantha Liss • July 11, 2022 -
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CMS proposed payment rule includes major updates for ACOs
Changes to the Medicare Shared Savings Program would give some accountable care organizations more time to ramp up to performance-based risk and updated quality reporting.
By Shannon Muchmore • July 8, 2022 -
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CMS finds 'troubling' implicit bias in 3 payment models
CMMI has taken initial actions to address existing bias, and has started developing a guide to screen and mitigate it in various models, according to a new article in Health Affairs.
By Rebecca Pifer Parduhn • July 8, 2022 -
Photo by Liza Summer from Pexels
'Phantom' provider lists limit Medicaid mental healthcare access, study finds
The Health Affairs research showed that inaccurate provider directories may create a barrier to treatment for a population that needs it most.
By Susan Kelly • July 6, 2022 -
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Marketplace insurers denied 18% of in-network claims in 2020, data shows
Five years into ACA-mandated transparency for coverage data, reporting for 2020 remained spotty, showing limited insight into coverage denials.
By Sydney Halleman • July 6, 2022 -
Social needs program for Medicaid beneficiaries can be effective but costly, research finds
The youngest patients enrolled in the program saw the greatest reduction in healthcare use while less of an impact was seen among older patients. Also, 60% of patients enrolled in the program did not engage.
By Hailey Mensik • July 5, 2022 -
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To aid rural hospitals, CMS proposes rule for new provider type
The rural emergency hospital designation is expected to help prevent facility closures and maintain access to crucial healthcare services.
By Susan Kelly • July 5, 2022 -
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CMS wants Tennessee to change Trump-approved Medicaid block grant plan
Regulators sent a letter to Tennessee requesting the state submit a new financing and budget neutrality model based on a traditional per member per month cap, instead of an aggregate cap, among other changes.
By Rebecca Pifer Parduhn • July 1, 2022 -
CMS insurer price transparency rule has taken effect. Signs are good for compliance
UnitedHealthcare, Anthem and Centene are among the major payers already hosting machine-readable cost files onsite.
By Rebecca Pifer Parduhn • July 1, 2022 -
Aetna rolls back prior authorization requirement for cataract surgery
The payer said its decision came after analyzing real-time data when the requirement was in place and that it will continue to perform retrospective reviews.
By Shannon Muchmore • June 30, 2022 -
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CVS long-term care unit Omnicare taps new president
Ahmed Hassan, who will assume the role Friday, will be tasked with leading CVS’ long-term care business and formulating business strategy.
By Sydney Halleman • June 30, 2022 -
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House hearing ups ante on Medicare Advantage reform
Lawmakers on both sides of the aisle are taking a harder look at coverage denials, fraud and waste in the popular program.
By Rebecca Pifer Parduhn • June 29, 2022 -
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Mass General Brigham's health plan launches rebrand as it looks to expand
AllWays Health Partners will change its name to Mass General Brigham Health Plan as it looks to leverage the name recognition of the system and deepen integration with the provider.
By Samantha Liss • June 29, 2022 -
Megan Quinn/Healthcare Dive
Democrat governors urge Congress to prevent 'disastrous' coverage loss by preserving ACA subsidies
The 14 governors said they’re concerned many Americans will be forced to reduce insurance coverage or forgo it entirely if Congress allows the subsidies to expire.
By Rebecca Pifer Parduhn • June 29, 2022 -
CMS launches voluntary incentive program aiming to cut cancer death rate
The Enhancing Oncology Model requires participating providers to offer services including patient navigation, 24-hour access to clinicians, a detailed care plan and screening for social needs.
By Susan Kelly • June 29, 2022
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