Payer: Page 60
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Courtesy of Exact Sciences
US panel trims colorectal cancer screening age, broadening payer mandate
The action means private insurers have to cover the screening of adults aged 45 to 49 years under the Affordable Care Act.
By Nick Paul Taylor • May 19, 2021 -
Bruce Bennett via Getty Images
Former Aetna exec becomes CVS CFO
Incoming finance chief Shawn Guertin was originally expected to take the job after the retail behemoth's 2018 acquisition of Aetna, but initially declined, citing personal and family reasons.
By Jane Thier • May 18, 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 -
Kena Betancur via Getty Images
Clover net loss balloons due to higher-than-expected medical costs
An ongoing SEC probe could pose a significant risk to the payer, which gets most of its revenue from government programs.
By Rebecca Pifer • May 18, 2021 -
Getty Images
Sponsored by ZSLife sciences' role in achieving health equity
How can we mend the industry's foundation? And, what role can life sciences companies play in healthcare's quest to improve healthcare for all?
By Nan Gu and Harshil Gagnani • May 17, 2021 -
Alex Wong via Getty Images
CMS again delays breakthrough device payment rule in nod to skeptics
Medtech manufacturers pushed for the MCIT rule, but high-profile detractors like payer lobby America's Health Insurance Plans and doctor groups drove CMS to delay implementation, citing potential risks to Medicare beneficiaries.
By Nick Paul Taylor • May 17, 2021 -
Almost all major US payers hiked forecasts following Q1, hinting at 2021 optimism despite COVID-19
Humana was the only major insurer not to increase its full-year earnings outlook following a strong quarterly showing in the benefits sector.
May 12, 2021 -
Cigna signals optimism for 2021 as it raises forecasts despite ongoing pandemic
The insurer bested Wall Street expectations in the first quarter with $1.2 billion in profit on $41 billion in revenue.
By Samantha Liss • May 7, 2021 -
Drew Angerer via Getty Images
ACA special enrollment period sign-ups surged in April
The Biden administration began the SEP primarily to help people who have lost coverage due to the COVID-19 pandemic and related economic fallout.
By Shannon Muchmore • May 7, 2021 -
Courtesy of Amwell
Cigna adds in-network virtual mental healthcare, highlighting focus on treatment access
Ginger provides Cigna customers with behavioral health coaching, therapy and psychiatry services through its app.
By Katie Clarey • May 5, 2021 -
Bruce Bennett via Getty Images
CVS profit up 10%, but warns vaccine hesitancy could dampen earnings
The diversified health behemoth beat Wall Street quarterly forecasts with revenue of $69.1 billion, raising its full-year guidance as a result.
By Rebecca Pifer • May 4, 2021 -
COVID-19 spurred growing profitability in insurance markets last year, KFF says
Still, the Kaiser Family Foundation report stressed the pandemic's long-term financial ramifications on insurers are uncertain, as a bounceback in utilization and shifting regulatory requirements could dampen future income.
By Rebecca Pifer • May 3, 2021 -
Getty Images
Sponsored by Pulse8Using risk adjustment analytics to precision target interventions
Dynamic intervention planning helps payers save time and money while reducing 20-30% interventions.
By Scott Stratton, MPH • May 3, 2021 -
Kentucky must rebid Medicaid contracts again, judge rules
This ruling puts six insurers at risk of losing their lucrative contracts with the state. It's unclear when the state will rebid the work.
By Samantha Liss • April 30, 2021 -
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 -
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 -
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
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