Doctor on Demand partners with Texas health plan for virtual primary care HMO

The telehealth vendor has a number of virtual primary care plans in development now, including some rolling out later this year, said David Deane, head of growth and strategy.

By Hailey Mensik • Jan. 14, 2021

ACA plan enrollment for 2021 ticked up slightly

Of the total, 23% of consumers were new and the rest renewed coverage. Repeat consumers who actively chose a new plan and those who were automatically re-enrolled both increased.

By Shannon Muchmore • Jan. 14, 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

Pandemic propels health systems to mull insurer acquisitions, partnerships: JPM21

Advocate Aurora CEO Jim Skogsbergh said "partnering for health plan capability is going to be critical to our success, and we are taking steps to do that."

By Samantha Liss • Jan. 13, 2021

CMS breakthrough rule cheered as tailwind for Abbott, J&J and Medtronic

The final rule enables developers of FDA-designated breakthrough products to get Medicare coverage for some 60 million beneficiaries on the day they win approval.

By Nick Paul Taylor • Jan. 13, 2021

Tennessee approved for first Medicaid block grant program

The waiver is approved for 10 years. The incoming Biden administration could attempt to roll it back, but the state would be able to challenge such a move.

By Shannon Muchmore • Jan. 8, 2021

With Democratic trifecta, Biden could shore up ACA

"A lot can be done with a simple majority vote in the Senate," Kaiser Family Foundation's Larry Levitt said on Twitter.

By Shannon Muchmore • Jan. 7, 2021

Kaiser Permanente ranked No. 1 in consumer satisfaction, Insure.com finds

An October survey of 2,200 consumers found a majority were generally pleased with their plans and would recommend it to others, despite 2020's historic healthcare uncertainty.

By Rebecca Pifer • Jan. 6, 2021

UnitedHealth's Optum to buy Change Healthcare in $13B deal

Change Healthcare CEO Neil de Crescenzo will become chief of OptumInsight after the deal closes in the second half of the year.

By Samantha Liss • Jan. 6, 2021

Medicaid expansion could help hospitals financially recover from pandemic, Health Affairs study suggests

Hospitals in states that expanded the safety net program under the Affordable Care Act on average saw lower uncompensated care costs and higher Medicaid revenue compared with those in states that have not, researchers found.

By Hailey Mensik • Jan. 5, 2021

Envision cut from UnitedHealthcare's network

The physician staffing firm has a significant footprint, with 25,000 clinicians in 44 states and D.C.

By Samantha Liss • Jan. 5, 2021

Centene's $2.2B deal for Magellan adds focus on behavioral health

The buy also boosts the insurer's footprint in government-sponsored health plans with the addition of 5.5 million lives and another 2.2 million to add to its pharmacy benefit management platform.

By Samantha Liss • Jan. 4, 2021

Oscar quietly readies for IPO

The startup insurer, co-founded by Josh Kushner, said the price range and size has yet to be decided. It's one of a spate of health-focused companies making the move in recent months.

By Samantha Liss • Dec. 22, 2020

CMS finalizes rule to ease value-based arrangements for prescription drugs

The changes, effective in 2022, overhaul existing regulations that stymied value-based payments in a bid to expand access to new, expensive drugs like gene therapies, the agency said.

By Rebecca Pifer • Dec. 22, 2020

ACA exchange enrollment for 2021 holds steady

About a quarter signed up for a plan for the first time — amid historic job losses — while the rest were returning customers or people who were automatically re-enrolled.

By Shannon Muchmore • Dec. 21, 2020

Provider-friendly surprise billing fix, more funds for hospitals in year-end spending bill

The final fix included in the legislation is almost exactly the same as the initial proposal greenlit last week by key congressional leaders, but includes additional concessions for providers.

By Rebecca Pifer • Dec. 21, 2020

Providers stumble in efforts to avoid HIPAA breaches: OCR

Although a survey did not find any glaring security lapses, the agency did find little adherence to some collateral safeguards, such as how patients are provided notifications regarding privacy practices.

By Ron Shinkman • Dec. 17, 2020

Stryker, Zimmer shift strategies to capitalize on growing ASC market

Now that Medicare has caught up to private payers' expansion of coverage policies, experts see the shift toward procedures outside of hospitals accelerating. Pricing pressure is a risk, though.

By Ricky Zipp • Dec. 16, 2020

Centene buys specialty pharmacy Pantherx for undisclosed sum

The acquisition was completed Wednesday. The specialty pharmacy will operate independently as part of the insurer's drug management program, as expected.

By Rebecca Pifer • Updated Jan. 4, 2021

Hospitals allege HHS let pharmas evade 340B drug discount rules

Led by California Attorney General Xavier Becerra, President-elect Joe Biden's pick to lead HHS, more than two dozen state attorneys general urged the agency to force drugmakers to comply with the program's rules.

By Hailey Mensik • Updated Dec. 15, 2020

Bipartisan agreement on provider-friendly surprise billing deal ups chance of passage

Disputes between health insurers and providers on how much to pay would be settled by an independent arbiter. The approach is favored by providers, while insurers back tying payments to median in-network rates.

By Rebecca Pifer • Dec. 14, 2020

CMS looks to crack down on prior authorization

The American Hospital Association cheered the news but was disappointed the proposal excluded Medicare Advantage plans.

By Samantha Liss • Dec. 11, 2020

Centene closes buy of analytics firm Apixio

It's the latest step in the payer's strategy to build out its back-end technology infrastructure. Financial terms of the purchase, first announced on Nov. 9, were not disclosed.

By Rebecca Pifer • Dec. 9, 2020

Oak Street to expand into 2 new states early next year

As part of its 2021 growth plans, the primary care chain intends to open centers in New Orleans, along with Columbia and Greenville in South Carolina, bringing its total footprint to 13 states.

By Rebecca Pifer • Dec. 9, 2020

The Healthcare Dive Awards for 2020

This year was unprecedented as healthcare workers around the globe battled the novel coronavirus. From those on the front lines to virtual care standout Teladoc, here are the people and companies that rose to the challenge.

By Healthcare Dive Team • Dec. 9, 2020

Finance Trend of the Year: Going public

"The wacky aspect of 2020 is we've had tons of uncertainty and we've had a really active IPO market. And I've never seen that in my 30-year career on Wall Street," Davide Ethridge, U.S. IPO services leader at PwC, said.

By Shannon Muchmore • Dec. 9, 2020